Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 4, Number 7, July 2013, pages 481-484

Dexmedetomidine and Pulmonary Hypertension: A Case Report and Review of the Literature


Table 1. Anecdotal Reports of Dexmedetomidine for Procedural Sedation in Patients With Pulmonary Hypertension
Author and referencesClinical situationDexmedetomidine dosing and outcome
PAH = pulmonary artery hypertension
Nathan AT et al [16]16-year-old with impending respiratory failure due to pneumonia. PAH due to chronic lung disease since infancy.Dexmedetomidine used to provide anxiolysis during increased work of breathing.The dexmedetomidine infusion was started at 0.5 µg/kg/hour and continued for 48 hours with effective pain control and anxiolysis.
Munro HM et al [17]12-year-old with idiopathic PAH undergoing cardiac catheterization for reactivity to guided therapeutic options.Ketamine 15 mg bolus times two followed by dexmedetomidine (loading dose of 1 µg/kg followed by an infusion of 1 µg/kg/hr). The dexmedetomidine infusion was continued at 0.5 µg/kg/hr for 2 hours postoperatively to provide sedation due to behavioral concerns. Hemodynamic stability maintained throughout.
Toyama H et al [18]30-year-old with severe PAH for caesarean section at 32 weeks under general anesthesia.Dexmedetomidine (0.4 µg/kg/hour) was used to provide postoperative anxiolysis and prevent emergence agitation following general anesthesia and during tracheal extubation.
Shinohara H et al [19]21-year-old requiring monitored anesthesia care during regional anesthesia for inguinal hernia repairDexmedetomidine at 0.2-0.3 µg/kg/hour used to provide sedation and anxiolysis during Ilioinguinal-iliohypogastric block and subsequent surgical procedural.