Dexmedetomidine

Pharmacological manipulation of the sympathetic tone has led to the synthes is of novel compounds to control stress-induced hemodynamic disorders. The use of alpha(2)-adrenoceptor agonists is particularly interesting in this r egard, since these agents decrease sympathetic activity by reducing norepin ephrine release from nerve terminals. Dexmedetomidine is a potent, highly s elective a,adrenoceptor agonist. Its use is associated with a decrease in h eart rate and blood pressure both in animals and humans. Several lines of e vidence suggest that this compound increases perioperative cardiovascular s tability and reduces the incidence of ischemic episodes in patients with co ronary artery disease. In addition to its cardiovascular properties, dexmed etomidine possesses anxiolytic, hypnotic/sedative, anesthetic-sparing and a nalgesic actions and is devoid of significant respiratory depressant effect s. Targeted mutations of the alpha(2) receptor site indicate that the alpha (2A) subtype is primarily involved in its sedative and anesthetic-sparing e ffects. Because of these properties, dexmedetomidine may be particularly us eful during the perioperative period, as well as for sedation of patients i n critical care settings. (C)1999 Prous Science. All rights reserved.