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25/11/2013

The Role of the 2-Adrenoceptor Agonist Dexmedetomidine in Postsurgical Sedation in the Intensive Care Unit
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Journal of Intensive Care Medicine


jic.sagepub.com
doi: 10.1177/0885066602239122
J Intensive Care Med January 2003 vol. 18 no. 1 29-41

The Role of the 2-Adrenoceptor Agonist


Dexmedetomidine in Postsurgical Sedation
in the Intensive Care Unit
Eike Martin
Graham Ramsay
Jean Mantz
S. T. John Sum-Ping

Abstract
Dexmedetomidine was evaluated for sedation of 401 postsurgical patients in this
double-blind, randomized, placebocontrolled, multicenter trial. Dexmedetomidine or
saline was started on arrival in the intensive care unit (ICU) (1.0 mcg/kg for 10
minutes), then titrated at 0.2 to 0.7 mcg/kg/h to effect. Patients could be given
propofol if necessary. Morphine was administered for pain. Sixty percent of the
dexmedetomidine patients required no other sedative to maintain an RSS 3; 21%
required < 50 mg propofol. In contrast, 76% of the control group received propofol;
59% required 50 mg. Dexmedetomidine patients required significantly less morphine
for pain relief (P < .001). Continuously given throughout the ICU stay,
dexmedetomidine had no effect on respiratory rate, oxygen saturation, duration of
weaning, or times to extubation. Nurses judged the dexmedetomidine patients were
easier to manage. Later, fewer dexmedetomidine patients remembered pain or
discomfort. The majority of dexmedetomidine patients maintained blood pressures
within normal range, without rebound. Hypertension, atelectasis, and rigors occurred
more frequently in the control group, while hypotension and bradycardia occurred more
frequently in the dexmedetomidine group. Preoperative cardiovascular conditions were
not risk factors for dexmedetomidine patients.
2-adrenoceptors

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