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Preliminary Experience With Dexmedetomidine for Monitored Anesthesia Care During ENT Surgical Procedures

Busick, Tamra DO1; Kussman, Mary MD1; Scheidt, Troy MD2; Tobias, Joseph D MD1,3*

doi: 10.1097/MJT.0b013e31815ae755
Original Article
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Dexmedetomidine is an α2-adrenergic agonist that produces anxiolysis, amnesia, sedation, potentiation of opioid analgesia, and sympatholysis. It is currently approved by the U.S. Food & Drug Administration for the sedation of adults in the intensive care setting for up to 24 hours during mechanical ventilation. Given its beneficial sedative and anxiolytic properties and limited adverse effect profile, it has been used in several other clinical scenarios. The authors present their experience using dexmedetomidine for monitored anesthesia care (MAC) during “awake” ENT procedures such as thyroplasty, a procedure requiring a patient to verbalize when requested but to otherwise remain immobile to allow for completion of the procedure, and in a patient with post-polio syndrome with poor pulmonary reserve requiring esophagoscopy with dilation and botulinum toxin injection for cricopharyngeal dysfunction. Our preliminary experience suggests that dexmedetomidine provides effective sedation as the primary agent for MAC during such procedures in adult patients. The end-organ effects of dexmedetomidine and previous reports of its use during MAC are reviewed.

1Departments of Anesthesiology, 2Otolaryngology, and 3Pediatrics, University of Missouri, Columbia, MO.

*Address for correspondence: Vice-Chairman, Department of Anesthesiology Chief, Division of Pediatric Anesthesiology, Russell and Mary Shelden Chair in Pediatric Intensive Care Medicine, Professor of Anesthesiology and Child Health, University of Missouri Department of Anesthesiology, 3W-27G HSC, One Hospital Drive, Columbia, MO 65212. E-mail: Tobiasj@health.missouri.edu

© 2008 Lippincott Williams & Wilkins, Inc.