La dexmédétomidine : raisonnement clinique en vue d'une utilisation pour la sédation en réanimation chez l'adulte

Dexmedetomidine has now been launched on the market, as a sedative agent used in intensive care unit, following regulatory approval in Europe. As compared to clonidine, the advantages of dexmedetomidine are as follows: faster onset of sedative effect even without loading dose, and faster hepatic excretion. As compared to conventional ICU sedatives, dexmedetomidine presents many advantages: absence of delayed emergence, lower incidence of delirium; absence of respiratory depression; improvement of left- and right-ventricular loading conditions. To enhance the sedative effect of dexmedetomidine, neuroleptics and non-opioid analgesics are the first choice in order to preserve the absence of respiratory depression. The clinical development of dexmedetomidine should be continued, bringing sedation to rationality, presently observed in the cardioventilatory management, with corresponding improvement in outcome.