Dexmedetomidine in Neurocritical Care

Abstract

Early and appropriate management of brain insults has significantly reduced patient morbidity and mortality. Neuromonitoring, neuroprotection and secondary brain injury prevention are the essential principals of brain injury management. In this literature review we have elaborated the neuroprotective role of dexmedetomidine (DEX), predominantly in different animal models of brain insults and reports in patients cared in a neurocritical care setting.  We undertook an electronic literature search of articles published in English prior to July 2019. This search resulted in inclusion of 59 studies from medical databanks such as PubMed, Scopus, EMBSCO, CINAHL, ISC and the Cochrane Library. The keywords used were brain, α2 agonist, neurocritical care and dexmedetomidine. DEX may have a neuroprotective effect in a broad spectrum of brain pathologies such as traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), ischemic stroke, intracerebral hemorrhage (ICH), and cerebral hypoxia. However, its neuroprotective role in status epilepticus (SE) is less clear. Further animal and human studies are needed before we could consider DEX as a neuroprotective agent in this patient population. Due to its favorable properties outlined in this review, DEX could be considered a favorable sedative agent in the neurocritical care settings