Abstract
The efficacy and safety of dexmedetomidine when used longer than the manufacturer-recommended 24 hours were evaluated. Dexmedetomidine is the newest agent available for use in the critical care setting to induce and maintain sedation and analgesia. However, concerns over efficacy and safety during prolonged administration are a limiting factor for use in this patient population. A literature review was conducted to assess the clinical evidence regarding the efficacy and safety of dexmedetomidine for longer than 24 hours. A total of 11 studies were identified. Of these trials, 6 included adult patients and 5 included pediatric patients. Of the 6 adult trials, 3 comparative trials demonstrated a similar efficacy with benzodiazepines (i.e., midazolam and lorazepam) or propofol, with a reduction in the incidence of delirium and coma associated with dexmedetomidine. In noncomparative trials, dexmedetomidine was efficacious in achieving sedation goals with only mild adverse effects. In the 5 pediatric trials evaluated, efficacy to achieve a target sedation scale score could not be assessed, as most studies did not use validated sedation scales to measure goal sedation. Alternatively, the safety of dexmedetomidine has been demonstrate...Continue Reading
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