New therapeutic uses for an alpha2 adrenergic receptor agonist--dexmedetomidine in pain management

Neurosci Lett. 2014 Feb 21:561:7-12. doi: 10.1016/j.neulet.2013.12.039. Epub 2013 Dec 25.

Abstract

Dexmedetomidine was initially approved for clinical use as a sedative. Its development in pain management has been limited. Dexmedetomidine has analgesic effects and analgesic-sparing properties, especially for patients with obstructed airways. Mixing dexmedetomidine with local anesthetics is a promising new avenue to enhance local anesthetics' effectiveness. Peripheral, spinal and supraspinal α(2A)-ARs are responsible for the analgesic function of dexmedetomidine. Animal studies have shown that antinociceptive synergism results from co-application of dexmedetomidine and opioids or local anesthetics. Dexmedetomidine has potential adverse effects such as hypotension and bradycardia. Therefore, dexmedetomidine is contraindicated for patients suffering from bradycardia or using β-adrenergic antagonists. Clinical trials of dexmedetomidine in chronic pain or hyperalgesia are lack.

Keywords: Alpha(2) adrenergic receptor; Alpha(2) adrenergic receptor agonist; Analgesia; Dexmedetomidine; Pain.

MeSH terms

  • Adrenergic alpha-2 Receptor Agonists / administration & dosage
  • Adrenergic alpha-2 Receptor Agonists / therapeutic use*
  • Analgesics, Non-Narcotic / administration & dosage
  • Analgesics, Non-Narcotic / therapeutic use*
  • Animals
  • Chronic Pain / drug therapy
  • Dexmedetomidine / administration & dosage
  • Dexmedetomidine / therapeutic use*
  • Humans
  • Intraoperative Period
  • Pain Management / methods*
  • Pain, Postoperative / drug therapy
  • Preoperative Period

Substances

  • Adrenergic alpha-2 Receptor Agonists
  • Analgesics, Non-Narcotic
  • Dexmedetomidine