Central α2-adrenoreceptor Agonists in Intensive Care
α2‐adrenoceptor agonists are well‐established as veterinary anesthetics but have only slowly entered human intensive care unit (ICU) and perioperative practice over the last 17 years. With many attractive properties in addition to sedation, including preservation of rousability, respiratory drive and airway reflexes at useful hypnotic doses, analgesia, anti‐inflammatory effects and potentially neuroprotective and anti‐delirium actions, they also avoid many of the adverse consequences of gamma‐aminobutyric acid (GABA)‐agonists, such as benzodiazepines and propofol. In this chapter, we will examine existing clinical evidence for use of α2‐adrenoceptor agonists for various indications, along with highlighting important studies currently underway. Suggestions for current clinical practice and for future research are made.
Clonidine (trade names include Catapres and Kapvay) is the prototypical α2‐adrenoreceptor agonist, first synthesized in the 1960s as a nasal...
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