Dexmedetomidine was not superior to propofol or midazolam for intensive care unit (ICU) sedation, led to more bradycardia and hypotension, and often required additional sedation. Prof. Yahya Shehabi (Monash Health, Australia) presented these data, which were simultaneously published in the New England Journal of Medicine [1,2].
Sedation of critically ill patients on ventilation is a part of their medical care, though the best choice of sedative is not definitively known. Dexmedetomidine, an adrenergic agonist of the alpha-2 receptor, may provide benefit as a sedative compared with traditional propofol or midazolam agents. Prior studies have shown an association between dexmedetomidine use and shorter time to extubation, reduced delirium, and lower mortality compared with other sedatives. The SPICE III trial (Sedation Practice in Intensive Care Evaluation) evaluated dexmedetomidine vs traditional...
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