Integrative review utilizing dexmedetomidine as an anesthetic for monitored anesthesia care and regional anesthesia.

BACKGROUND: Dexmedetomidine is increasingly being used as a sedative for monitored anesthesia care (MAC) with regional anesthesia. This literature review critiques 12 studies that used dexmedetomidine as the primary anesthetic. Study designs include prospective, retrospective case studies and randomized double-blind and randomized single-blind studies.

METHODS: Twelve studies utilizing dexmedetomidine as the primary anesthetic that were found via electronic databases including CINAHL, Ovid, and MEDLINE. All studies were completed within the past 10 years and met inclusion and exclusion criteria.

RESULTS: The results of dexmedetomidine efficacy as a primary anesthetic agent for MAC procedures varied. There is significant evidence showing that dexmedetomidine is not an appropriate anesthetic for colonoscopies, though there were mixed results showing its efficacy in ENT and dental procedures. Despite that, dexmedetomidine has been shown to be successful in orthopedic, vascular, plastic, lithotripsy, and diagnostic procedures, though patients are at increased risk of recall.

CONCLUSION: Dexmedetomidine is an effective MAC anesthetic for specific procedures. Further research is needed to determine which specific procedures are appropriate for dexmedetomidine. Lastly, dexmedetomidine is more costly than current MAC anesthetics, making it difficult to justify its use.