Review Article
Sedation in Traumatic Brain Injury
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Dexmedetomidine | Group | Selective α2 adrenergic agonist |
| Mechanism of Action/Pharmacodynamics | Peripheral α2A, brain & spinal cord α2B, α2C adrenoreceptor subtypes |
| Neuroprotective effects | Reduces CBF and ICP |
| Pharmacokinetics
| Hepatic metabolism Distribution 6 minutes Elimination 2 hours |
| Advantages | Minimal respiratory depression Reduction in delerium |
| Disadvantages and major side effects | Hypotension (28%) Bradycardia Arrhythmias including atrial fibrillation Relatively high cost |
| Dosage | Loading dose: 1 mcg/kg Infusion: 0.42–1.0 mcg/kg/hour |
| Other significant facts | Minimal effect on respiratory function |
| Appropriate uses in TBI | Maintenance sedation agent pre & post extubation Management of agitated delirium |
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