Dexmedetomidine as a sedative agent for more than 24 hours in acutely ill patients

Objective

To retrospectively review dexmedetomidine infusion for more than 24 hours in acutely ill patients and to evaluate its safety profile.

Design and setting

A retrospective observational study in a tertiary general hospital, mixed ICU.

Patients

Fifty-seven patients who were assigned to dexmedetomidine use for more than 24 hours over a 12-month period.

Results

From January to December 2004, 57 patients were included. Most patients were male (71.9%) and the mean age was 55.6 years (19–93 years); the mean APACHE II score was 17.5 (6–41). The mean ICU and hospital lengths of stay were 15.4 and 43.5 days, respectively. There were 32 medical patients and 25 emergency and elective postoperative care admissions. The mean duration of drug infusion was 82.2 hours (25–408 hours), and 100% of the patients were on coadjuvant sedative agents when dexmedetomidine was started. Hypotension episodes occurred in five patients (8.7%) receiving the drug for more than 24 hours, and no bradycardia episodes were noted. Six patients (10.9%) died during the hospital stay, but they were not timely related to the dexmedetomidine infusion.

Conclusions

The safety profile of dexmedetomidine use, as a coadjuvant sedative agent, for more than 24 hours in the ICU setting is comparable with its use for less than 24 hours. No clinically relevant side effects directly related to the study drug were observed after a 24-hour infusion period.