Revisiting the clinical evidence and economics of dexmedetomidine use

A recent meta-analysis reported by Chen et al.1 under the Cochrane Anaesthesia Group assessed the safety and efficacy of dexmedetomidine for sedation of more than 24 h among mechanically ventilated critically ill adults. The results of Chen et al.’s meta-analyses1 showed a consistent trend across all the included studies, indicating a reduction in ventilation time with dexmedetomidine. A 14% reduction in the length of time spent in intensive care unit (ICU) was observed. This is likely to be the result of reduced ventilation time, but it could be due to the additional analgesic effect of dexmedetomidine.1 It must be noted that out of the four studies that reported a benefit from dexmedetomidine in terms of shorter mechanical ventilation duration, all were statistically significant, except one by Ruokonen et al.2