This case illustrates how useful DXM could be for borderline applications using sedation and analgesia, in addition to the stability provided in high-risk procedures. This is even more valid considering the effects on the pulmonary vasculature, gas exchange and the right ventricle 6. 1. Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine: a review of clinical applications. Curr Opin Anaesthesiol. 2008;21:457-61. 2. Bekker AY, Basile J, Gold M, et al. Dexmedetomidine for Awake Carotid Endarterectomy: efficacy, hemodynamic profile, and side effects. J Neurosurg Anesthesiol. 2004;16:126-35. 4. Mato M, Pérez A, Otero J, et al. Dexmedetomidina, un fármaco prometedor. Rev Esp Anestesiol Reanim. 2002;49:407-20. 5. Rozet I. Anesthesia for functional neurosurgery: the role of dexmedetomidine. Curr Opin Anaesthesiol. 2008;21:537-43. 6. Wagner DS, Brummett CM. Dexmedetomidine: as safe as safe can be. Seminars in Anesthesia Perioperative Medicine and Pain. 2006;25:77-83. 7. Gurbet A, Basagan-Mogol E, Turker G, et al. Intraoperative infusion of dexmedetomidine reduces perioperative analgesic requirements. Can J Anesth. 2006;53:646-52. 8. Talke PO, Caldwell JE, Richardson CA, et al. The effects of dexmedetomidine on neuromuscular blockade in human volunteers. Anesth Analg. 1999;88:633-9. 9. Martin E, Ramsay G, Mantz J, et al: The role of the alpha2-adrenoceptor agonist dexmedetomidine in postsurgical sedation in the intensive care unit. J Intensive Care Med. 2003;18:29-41. 10. Aantaa R, Jalonen J. Perioperative use of alpha2- adrenoceptor agonists and the cardiac patient. Eur J Anaesthesiol. 2006;23:361-72. 11. Ho AM, Chen S, Karmakar MK. Central apnoea after balanced general anaesthesia that included dexmedetomidine. Br J Anaesth. 2005;95:773-5. 12. Ingersoll-Weng E, Manecke G, Thistlethwaite P. Dexmedetomidine and cardiac arrest. Anesthesiology. 2004;100:738-9. 13. Shah AN, Koneru J, Nicoara A, et al. Dexmedetomidine related cardiac arrest in a patient with permanent pacemaker; a cautionary tale. Pacing Clin Electrophysiol. 2007;30:1158-60.
Este caso muestra que la utilidad de la DMX se podría extender a situaciones límite, en las cuales se brinda sedación y analgesia de la mano con la estabilidad para procedimientos de alto riesgo; más aún, cuando se tienen en cuenta los efectos que se producen en la vasculatura pulmonar, el intercambio gaseoso y el ventrículo derecho 6.