Recent perspectives regarding dexmedetomidine: highlights from anesthesiology and perioperative science

instance, remimazolam, an ultra-short-acting benzodiazepine with rapid onset and modest hemodynamic effects, is now well characterized for procedural sedation in adults, although its routine use in children remains unestablished [5,6].Meanwhile, esketamine reduces desaturation and hypotension during gastrointestinal endoscopy [7], helps maintain hemodynamic stability in emergency trauma care [8], lowers acute pain scores after thoracoscopic surgery [9], and is associated with a lower incidence of rebound pain after peripheral nerve block [10].Progress has also been made in the design of anesthetics.ET-26, an etomidate analogue modified at the ester side chain, achieved comparable induction success with only slight and transitory adrenocortical suppression and recovery within 24 h in a phase II multicenter randomized trial [11], illustrating that anesthetic efficacy and endocrine safety must be considered together.These developments shift the clinical question from which agent is best in general to which agent suits a given patient and setting, the same question that now confronts dexmedetomidine.