Perioperative use of alpha2-adrenoceptor agonists and the cardiac patient

European Journal of Anaesthesiology
R Aantaa, J Jalonen

Abstract

The centrally acting alpha2-adrenoceptor agonists clonidine and dexmedetomidine have been used with success to provide haemodynamic stability for patients undergoing surgery. Particularly in the case of patients with overt or underlying cardiac disease the actions of alpha2-adrenoceptor agonists, which include maintenance of stable systemic blood pressure and low heart rate and a reduction in overall oxygen consumption, can be expected to reduce the risk of procedure-related cardiac events. This expectation has been corroborated in clinical trials with clonidine, dexmedetomidine and mivazerol and meta-analyses; additional large controlled trials would be instructive in establishing a robust estimate of the scale of the benefit. In addition, alpha2-adrenoceptor agonists used as premedication have been shown to substantially reduce anaesthetic requirements among surgical patients, and the use of these agents has been associated with a reduced risk of postoperative delirium, which may be expected to improve considerably the postoperative course for at-risk patients. Dexmedetomidine is the only alpha2-adrenoceptor agonist currently approved for use in the intensive care unit. A distinctive feature of dexmedetomidine in that setting...Continue Reading

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Citations

Feb 11, 2011·British Journal of Anaesthesia·T IirolaK T Olkkola
May 25, 2011·BMC Anesthesiology·Kari LeinoUNKNOWN Dexmedetomidine in Cardiac Surgery Study Group
Feb 7, 2009·Critical Care : the Official Journal of the Critical Care Forum·Stefan HoferMarkus A Weigand
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