The uses of dexmedetomidine has been expanding since its incorporation as a sedative and anesthetic agent. One of its highlighted properties is that, unlike many other anesthetic agents, it does not inhibit respiratory function. It also has anxiolytic and sedative effects, which make it a drug that is used more and more in surgical procedures with total intravenous anesthesia (TIVA), usually in combination with other drugs.
Dexmedetomidine is also being used in neurosurgical procedures such as craniotomy with awake patients, in which the neurosurgeon needs the patient to be able to speak, move his/her limbs and respond to orders to ensure that the operation does not affect motor areas or speech centers in the brain. Dexmedetomidine-induced sedation has been described as “cooperative” and “wakable.”
The use of dexmedetomidine is not limited only to the operating room, since it is also used in ICU for intubation and/or extubation procedures or as a sedative. In fact, the initial U.S. FDA approval restricted its use to the ICU, later expanding its use to other fields.
Using dexmedetomidine in the operating room
Although there is medical literature on the use of dexmedetomidine as the sole anesthetic agent, it is usually used in combination with other drugs in total intravenous anesthesia (TIVA) procedures. Its effects are dose-dependent. As such, the use of a TCI pharmacokinetic model is essential so that the anesthesiologist can have control over the tissue concentration of the drug at all times.
Dexmedetomidine reduces the requirements of other drugs in TIVA anesthesia. It has predictable cardiovascular and respiratory effects, in addition to providing neurovegetative protection and anxiolysis. It decreases the metabolic oxygen demand of the brain, has an antiarrhythmic effect and decreases peripheral vasoconstriction, with the consequent effect of lowering blood pressure.
Arcomed Chroma infusion pumps exclusively include the TCI Dyck model for dexmedetomidine, which facilitates its use and saves the anesthesiologist from having to perform complex calculations, as simply entering the patient’s biometric parameters and the target concentration in effect plasmatic site, the algorithm calculates the right dosage for induction bolus and maintenance phase. In addition, this data entry only needs to be done once when several pumps are used together (which is common in TIVA), since wireless communication between pumps allows the transmission of patient data from one pump to another.
At arcomed we have a firm commitment to incorporating the latest innovations, both in technology and in pharmacokinetic models, in our infusion pumps, always in close cooperation with health professionals. Simplicity and state-of-the-art technology make arcomed infusion pumps the right choice in any hospital.