Dexmedetomidine as a total intravenous anesthetic agent.

DEXMEDETOMIDINE is a highly selective 2 adrenoceptor agonist that has sedative and analgesic properties with associated reduction in opioid and anesthetic requirements. One significant advantage of dexmedetomidine is that in the clinical dose range there is no respiratory depression. The agonistic action on the 2 adrenoceptors in the sympathetic ganglia modulates the release of catecholamines, resulting in a sympatholytic effect and reports of bradycardia and hypotension. As the dose of dexmedetomidine is increased, there is a direct action on the blood vessels causing vasoconstriction and a possible increase in blood pressure. This report describes three patients who presented for surgery with potential airway management challenges. Dexmedetomidine was administered to these patients in increasing doses until general anesthesia was attained. The effects of these high doses of dexmedetomidine on respiratory function and hemodynamics are described. The rate of dexmedetomidine infusion was administered based on actual patient body weights.