Intraoperative Use of Dexmedetomidine in Pediatric Patients : Advantages and Disadvantages

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  • ABUKAWA Yukako
    Department of Anesthesia, Tokyo Women's Medical University Hospital
  • HIROKI Koichi
    Department of Anesthesia, Tokyo Women's Medical University Hospital Department of Anesthesia, Kanagawa Children's Medical Center
  • OZAKI Makoto
    Department of Anesthesia, Tokyo Women's Medical University Hospital

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  • 小児のデクスメデトミジン（DEX）の術中使用─利点と欠点─

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  In pediatric anesthesia, dexmedetomidine (DEX) is used off-label all over the world. I herein describe the present conditions, and the advantages of using DEX based on the current literature.<br>  DEX is associated with several advantages, including the fact that it induces minimal respiratory depression, and it has a pain-killing effect in addition to an antianxiety effect. The disadvantages of DEX are that it must be used off-label and can lead to changes in blood pressure and heart rate depending on the dose administered. <br>  In our institution, DEX is used for children aged five to seven years old who are undergoing a pectus excavatum operation and being treated using patient-controlled epidural or intravenous analgesia. We do not use a loading dose because it can lead to changes in blood pressure and heart rate. We start to inject a concentration of 0.4 μg/kg/hr DEX intravenously when the wound is sutured. We can reduce the risk of respiratory failure, allow for smooth extubation, and make the stay in the ICU more comfortable using DEX. <br>  I believe that the drug will likely be adopted in the future, and it appears to be an especially useful drug in the field of pediatric anesthesia.

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