Dexmedetomidine As a Welcomed Gest in Anesthesia: Review Article | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 90, Volume 100, Issue 1, July 2025, Page 3169-3172 PDF (225.99 K) | ||||
| DOI: 10.21608/ejhm.2025.442681 | ||||
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| Abstract | ||||
| Background: Hemidiaphragmatic paralysis is a known complication of ultrasound-guided supraclavicular brachial plexus blockade (SCB) in patients undergoing upper limb surgery. This study explores the incidence, mechanisms, and clinical implications of this phenomenon, with a focus on the role of dexmedetomidine as an adjuvant in regional anesthesia. Dexmedetomidine, a highly selective α2-adrenergic receptor agonist, has gained prominence for its sedative, analgesic, and anxiolytic properties without significant respiratory depression. Its use as an adjuvant in SCB has been shown to prolong sensory and motor block duration, though its impact on hemidiaphragmatic function remains a critical consideration. Objective: The review highlights the pharmacological profile of dexmedetomidine, including its mechanism of action, pharmacokinetics, and clinical applications in anesthesia. Special attention is given to its role in enhancing peripheral nerve blocks, procedural sedation, and opioid-free anesthesia, while also addressing potential adverse effects such as cardiovascular instability. Emerging applications in neuroprotection, substance abuse withdrawal, and delirium prevention are discussed, underscoring the drug's expanding utility in perioperative care. Methods: We searched PubMed, Google Scholar, and Science Direct for Dexmedetomidine, Hemidiaphragmatic paralysis, Brachial plexus block, Regional anesthesia, Opioid-free anesthesia and Perioperative care. Only the most recent or thorough investigation, from 2011 to 2023 was taken into account. The writers evaluated relevant literature references as well. Documents written in languages other than English have been ignored. Papers that were not regarded as significant scientific research included dissertations, oral presentations, conference abstracts, and unpublished manuscripts were excluded. Conclusion: This study synthesized current evidence to evaluate the balance between the benefits of dexmedetomidine in improving anesthesia outcomes and the risks of complications like hemidiaphragmatic paralysis. The findings aimed to guide clinicians in optimizing patient safety and efficacy when incorporating dexmedetomidine into regional anesthesia protocols. | ||||
| Keywords | ||||
| Dexmedetomidine; Hemidiaphragmatic paralysis; Brachial plexus block; Regional anesthesia; Opioid-free anesthesia; Perioperative care | ||||
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