Study: Increasing Dexmedetomidine Dose Does Not Enhance Sedation

A study published in the June 2011 issue of the Annals of Pharmacotherapy indicates that increasing doses of the drug dexmedetomidine may not enhance sedation in critically ill patients, according to an Anesthesiology News report.

The drug received FDA approval in 1999 and was expected to replace or provide an alternative to other agents. The FDA recommended an initial dose of 1 mcg/kg of predicted body weight, then 0.7 mcg/kg per hour of continuous infusion for up to 24 hours. According to the study, hospitals have more recently allowed physicians to increase dexmedetomidine doses to 1.4 mcg/kg per hour. The study was designed to analyze whether this increase enhances sedation in ICU patients.

The study identified 133 patients in the ICU who received dexmedetomidine for continuous sedation. Patients were placed in the low-dose group if their maximum dose was less than or equal to 0.7 mcg/kg and in the high-dose group if they received a dose exceeding 0.7 mcg/kg.

The researchers evaluated patients based on which patients maintained a Richmond Agitation and Sedation Scale Score of -1 to +1, the recommended sedation level at the hospital where the study was conducted. The team found that more patients in the low-dose group maintained RASS scores in the goal range. They found no difference in the rate of oversedation between the two groups.

Read the Anesthesiology News report on dexmedetomidine.

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