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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 December;83(12):1294-308

DOI: 10.23736/S0375-9393.17.12040-7

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Dexmedetomidine and general anesthesia: a narrative literature review of its major indications for use in adults undergoing non-cardiac surgery

Arthur DAVY 1, 2, Julien FESSLER 1, 2, Marc FISCHLER 1, 2 , Morgan LE GUEN 1, 2

1 Department of Anesthesiology, Foch Hospital, Suresnes, France; 2 University of Versailles Saint Quentin in Yvelines, Versailles, France


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INTRODUCTION: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia.
EVIDENCE ACQUISITION: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords “Dexmedetomidine, Dexdor, Precedex and Dexdomitor.” The research ended in December 2016. Studies were eligible for inclusion if they reported the use of dexmedetomidine in adults receiving general anesthesia. We excluded studies related to cardiac surgery and studies reporting the use of dexmedetomidine as an adjuvant of locoregional anesthesia.
EVIDENCE SYNTHESIS: Several potential uses for dexmedetomidine during general anesthesia are described, especially: awake fiber optic intubation, the sparing effect of dexmedetomidine on hypnotic and opioid drugs, prevention of postoperative pain, nausea and vomiting and shivering, improvement of postoperative sleep and postoperative recovery, opioid-free anesthesia, use in craniotomy, endovascular stroke treatment and drug-induced sleep endoscopy. A protective effect against cardiac complications, an anti-inflammatory effect, and side effects, particularly bradycardia, are also described.
CONCLUSIONS: The properties of dexmedetomidine lead to its use for elective indications such as awake fiberoptic intubation and neurosurgical anesthesia. New topics are under debate. These subjects must be studied thoroughly because of their implication in the patients’ surgical course. These advantages must be weighed against the major drawback of dexmedetomidine administration which is the potential for hemodynamic abnormalities.


KEY WORDS: Dexmedetomidine - Anesthesia, general - Adult

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Publication History

Issue published online: December 20, 2017
Article first published online: June 22, 2017
Manuscript accepted: June 15, 2017
Manuscript revised: June 7, 2017
Manuscript received: Marh 5, 2017

Cite this article as

Davy A, Fessler J, Fischler M, Le Guen M. Dexmedetomidine and general anesthesia: a narrative literature review of its major indications for use in adults undergoing non-cardiac surgery. Minerva Anestesiol 2017;83:1294-308. DOI: 10.23736/S0375-9393.17.12040-7

Corresponding author e-mail

m.fischler@hopital-foch.org