Use of dexmedetomidine in neurosurgical procedures

Abstract

Dexmedetomidine, a highly selective alpha-2 adrenergic receptor agonist, is gaining prominence in neurosurgery due to its unique sedative, analgesic, and neuroprotective properties. This review explores its pharmacodynamics, including its effects on cerebral blood flow and metabolism, and its clinical applications in deep brain stimulation, awake craniotomy, awake fiberoptic intubation, and as an adjunct to general anesthesia. With an arousable sedation profile and minimal respiratory depression, dexmedetomidine enhances patient cooperation and hemodynamic stability. Emerging evidence suggests potential benefits in neuroprotection and delirium prevention, though further research is needed to optimize dosing and confirm these effects in neurosurgical settings.

Keywords: Dexmedetomidine, neurosurgery, sedation, neuroprotection, awake craniotomy, deep brain stimulation, delirium prevention.