Dexmedetomidine Complications When Large Doses Are Used, Measures To Be Taken

Dexmedetomidine - A wonderful safe drug with a very good margin of safety in all routes  IM, IV, Intrathecal, epidural, nerve blocks etc. In high doses (100- 200mcg) through any route,  Dexmedetomidine stimulates alpha -1 receptors also, along with central alpha -2 receptors. This though transient leads to: High rise in Blood pressure, High Systemic Vascular Resistance,   reflex bradycardia,   Sometimes Heart failure with high ST elevations, Myocardial strain pattern. One should keep this in mind while using this wonderful drug.

This problem can be handled by lowering systemic vascular resistance with a Calcium channel blocker oral, IV, or sublingual prior to or after use of high doses of Dexmedetomidine. Nasal NTG, intravenous NTG infusion etc.can also be used to handle this complication. With the little care,  intrathecal dexmedetomidine 200 mcg can be used very safely for…