The Effects of Increasing Plasma Concentrations of Dexmedetomidine in Humans

@article{Ebert2000TheEO,
  title={The Effects of Increasing Plasma Concentrations of Dexmedetomidine in Humans},
  author={Thomas J. Ebert and J. E. Hall and Jill A. Barney and Toni D. Uhrich and M D Colinco},
  journal={Anesthesiology},
  year={2000},
  volume={93},
  pages={382-394}
}
Background This study determined the responses to increasing plasma concentrations of dexmedetomidine in humans. Methods Ten healthy men (20–27 yr) provided informed consent and were monitored (underwent electrocardiography, measured arterial, central venous [CVP] and pulmonary artery [PAP] pressures, cardiac output, oxygen saturation, end-tidal carbon dioxide [ETCO2], respiration, blood gas, and catecholamines). Hemodynamic measurements, blood sampling, and psychometric, cold pressor, and… 
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References

SHOWING 1-10 OF 47 REFERENCES
Effects of intravenous dexmedetomidine in humans. I. Sedation, ventilation, and metabolic rate.
TLDR
Overall, across all the DMED doses, the slope was decreased (P < .05) at all times after DMED, and the placebo group showed a progressive increase in the HVR slope.
Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes.
TLDR
DMED is a more highly selective alpha 2-adrenergic agonist than clonidine that has sedative, analgesic, and cardiovascular stabilizing qualities and was well tolerated in the healthy volunteers.
Oral dexmedetomidine attenuates hemodynamic responses during emergence from general anesthesia in chronically instrumented dogs.
TLDR
Assessment of the hemodynamic effects of orally administered dexmedetomidine in chronically instrumented dogs in the conscious state, during enflurane anesthesia, and after emergence found that administration of dexmedETomidine before enflorane anesthesia also was associated with a reduction in heart rate and rate-pressure product.
Clonidine reduces sympathetic activity but maintains baroreflex responses in normotensive humans.
TLDR
Clonidine subtly reduced the sympathoexcitation produced by the cold pressor test but did not alter the gain of the baroreceptor reflex regulating cardiac interval or peripheral SNA; baroslope relationships were simply shifted leftward (to operate at lower pressures).
Effects of clonidine on anesthetic drug requirements and hemodynamic response during aortic surgery.
TLDR
The authors conclude that the preoperative administration of clonidine decreased the need to supplement anesthetic, and modifies the profile of distribution of heart rate and blood pressure.
Effects of dexmedetomidine, a selective α2‐adrenoceptor agonist, on hemodynamic control mechanisms
TLDR
Dexmedetomidine is a potentially useful tool for studies of the physiology and pharmacology of α2‐adrenoceptors in human beings and may have therapeutic applications in clinical conditions in which sedative and sympatholytic effects are considered beneficial, such as premedication for anesthesia and surgery.
The effect of intravenously administered dexmedetomidine on perioperative hemodynamics and isoflurane requirements in patients undergoing abdominal hysterectomy.
TLDR
The effects of two doses of dexmedetomidine as a single intravenous bolus administered 10 min prior to the induction of anesthesia were assessed in 96 women undergoing abdominal hysterectomy in a double-blind, randomized study.
Effects of Perioperative Dexmedetomidine Infusion in Patients Undergoing Vascular Surgery
TLDR
Infusion of dexmedetomidine up to a targeted plasma concentration of 0.45 ng/ml appears to benefit perioperative hemodynamic management of surgical patients undergoing vascular surgery but required greater intraoperative pharmacologic intervention to support blood pressure and heart rate.
The effects of the stereoisomers of the alpha 2-adrenergic agonist medetomidine on systemic and coronary hemodynamics in conscious dogs.
TLDR
The results indicate that the D-isomer of medetomidine is stereospecific for alterations in hemodynamics: the active D- isomer produces decreases in heart rate, arterial pressure, and the rate-pressure product via diminished sympathetic and/or augmented parasympathetic tone.
Dexmedetomidine as an Anesthetic Adjunct in Coronary Artery Bypass Grafting
TLDR
Intraoperative intravenous infusion of dexmedetomidine to patients undergoing coronary artery revascularization decreased intraoperative sympathetic tone and attenuated hyperdynamic responses to anesthesia and surgery but increased the propensity toward hypotension.
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