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SAAD Digest
March 2024
Volume: 40
Issue: 1

Title: Dexmedetomidine: pharmacology and use as a sedative agent
Author(s): C. Richards

Abstract: 

With the recent introduction of remimazolam into conscious sedation for dentistry there is a natural interest in the possibility of other drugs suitable for sedation in the field. This review explores the drug dexmedetomidine, an alpha adrenoceptor agonist first approved for use in intensive care units for short term sedation on intubated patients. It has sedative, analgesic, anxiolytic and antihypertensive properties. Interest was first sparked in dexmedetomidine as it was merited for having minimal impact on respiration, in comparison to midazolam which causes respiratory depression.

This review explores the literature of the pharmacodynamic and pharmacokinetic properties, followed by evaluation of the five available randomised control trials in the literature that compare midazolam with dexmedetomidine for procedural sedation in dentistry.

Overall, although dexmedetomidine seems to be associated with improved patient satisfaction and operator satisfaction with patients more relaxed during treatment, the limitations of being unable to use this drug as an operator sedation technique and the potential significant cardiovascular changes mean that dexmedetomidine is unlikely to ever become a drug of choice for intravenous conscious sedation in dentistry.

If you have a query relating to this article please email: digest@saad.org.uk

Articles from Digest 40(1)

 Article title
 Page start
Page end
 Editorial
 2
 2
Peer reviewed papers
Remimazolam compared to midazolam for dental sedation: an umbrella review
 3
 8
A review of the awareness and use of airway assessment techniques in conscious sedation in dentistry
 9
 14
Improving safety and efficiency in special care dentistry through quality improvement of patient information in the Belfast Trust  
 15
 18
Patient experiences and outcomes following intravenous sedation in an oral surgery setting 
 19
 22
An investigation of bispectral index monitoring when providing intravenous sedation for adults with severe cognitive disability 
 23
 27
Are we providing an effective sedation service? An evaluation of a new conscious sedation service in primary special dental care 
 28
 32
An audit of the use of flumazenil for sedation within the Special Care Dentistry Department (CDS Cycle 7) and seven-year comparison 
 33
 36
Unsuccessful conscious sedation on patients with a learning disability and / or autism: a multi-site service evaluation
 37
 41
The effectiveness of dental nurse led Cognitive Behavioural Therapy (CBT) on the dentally anxious patient: a service evaluation
 42
 46
Case reports
Dental treatment for a 15-year-old patient with Nicolaides- Baraitser Syndrome, under intravenous sedation with midazolam: a case report
 47
49 
The use of inhalation sedation to manage delayed eruption of permanent teeth, hypodontia and caries in a child patient 
 50
53
Case report: A paediatric patient with molar incisor hypomineralisation and hypodontia, treated with inhalation and intravenous sedation for extractions of deciduous and permanent molars 
 54
 56
Opinion
 57
 59
Journal Scan
 60
 68
Essay prizes
Dexmedetomidine: pharmacology and use as a sedative agent 
 69
 76
Do children from more deprived backgrounds have a higher chance of becoming dentally anxious?
 77
 80
Symposium 2023
 81
 89
Profile
 90
90 
Forum  92 97