THE USE OF DEXMEDETOMIDINE

IN CLINICAL PRACTICE

Robert Kraczkowski, DVM

„Szmaragdowa” Veterinary Clinic Lublin, Poland

Robert Kraczkowski, DVM

GO TO: pollev.com/rkraczkowski792
 THE GROUP OF ALFA-2-
ADRENERGIC RECEPTORS AGONIST
• clonidine

• xylazine

• romifidine

• detomidine

• medetomidine

• dexmedetomidine

Robert Kraczkowski, DVM

 WHAT IS AN ALPHA-2-
ADRENERGIC RECEPTOR AGONIST?

Robert Kraczkowski, DVM

 ADRENORECEPTORS IN THE
BODY
xylazine
1:160
• alpha-1: myocardium?, smooth 

vascular muscles

DEXMEDETO
• alpha-1 and alpha-2 ratio
-MIDINE

1:1620

Robert Kraczkowski, DVM

 WHERE DOES DEXMEDETOMIDINE
COME FROM?

MEDETOMIDINE

LEVOMEDETOMIDINE
DEXMEDETOMIDINE

Robert Kraczkowski, DVM

 MEDETOMIDINE

LEVOMEDETOMIDINE
DEXMEDETOMIDINE

Robert Kraczkowski, DVM

 NOT JUST FOR PREMEDICATION ! 

THE USE OF DEXMEDETOMIDINE IN CLINICAL
• sedation
PRACTICE
• analgo-sedation (for example, when combined with an opioid)

• premedication

• general anaesthesia - TIVA, PIVA, BA

• analgesia

• post-anaesthesia sedation

• locoregional anaesthesia

• pain management

Robert Kraczkowski, DVM

 USES OF 

IN DOGS AND CATS

• clinical examination

• orthopaedics exams

• radiography and ultrasound

• wound management

• abscess treatment, suture removal, skin biopsy

• grooming

Robert Kraczkowski, DVM

 DEXDOMITOR - ROUTES OF
ADMINISTRATION
• intramuscular

• intravenous

• subcutaneous

• epidural

• oral-transmucosal OTM

• orally

Robert Kraczkowski, DVM

 ACTIONS AND EFFECTS

• a reduction in HR after dexmedetomidine administration

is a physiological response

• positive and negative impacts are dose dependent

Robert Kraczkowski, DVM

Robert Kraczkowski, DVM
 DOSAGE
• the dosage of body surface area ?

• 1 - 3 mcg/kg IV - calm, light sedation

• VERY SLOWLY, WHEN GIVEN IV

• 5 - 7 mcg/kg IM - mild sedation

• 10 mcg/kg IM and more - deep sedation

• +/- others anaesthetics

Robert Kraczkowski, DVM

Robert Kraczkowski, DVM
 DOSAGE

• only one? - 40 mcg/kg

• only IM?

• 5-7-10 mcg/kg IM

• +/- others anaesthetics

Robert Kraczkowski, DVM

Robert Kraczkowski, DVM
Robert Kraczkowski, DVM
 +
• opioids

• benzodiazepines

• dissociative agents

• intravenous anaesthetics

• inhalant anaesthetics

• NSAID's

Robert Kraczkowski, DVM

Robert Kraczkowski, DVM
 AND THE TIME

• peak of sedation

- IM: 20 min

- IV: 2 - 3 min

• duration of action:

- sedation 2-3 h

- analgesia 0,5 - 1 h

Robert Kraczkowski, DVM

 DEXDOMITOR USED AS A PAIN
KILLER

• intra-anaesthesia bolus - 0.5 -1 mcg/kg very slowly IV

• CRI: 0.5 - 2.5 mcg/kg/h IV (after preloaded bolus 


or without)

Robert Kraczkowski, DVM

 1 mg = 1000 micrograms

0.5 mg/ml = 500 mcg/ml

0.1 mg/ml = 100 mcg/ml

Robert Kraczkowski, DVM

Robert Kraczkowski, DVM
 • alpha-2 adrenoreceptors antagonist

• reverse:

- sedative effects

- analgesia

- cardiovascular effects

Robert Kraczkowski, DVM

 ANTISEDAN’S TIPS
• starting at the lower doses!

• routes of administration: IM, (IV, SQ, IP)

• when ketamine has been combined with Dexdomitor, the

Antisedan can be applied at least 20 min after in the case
of cats, 40 min after in the case of dogs

Robert Kraczkowski, DVM

 TAKE-HOME MESSAGES
• Dexdomitor is the most specific and selective new generation
alfa-2-adrenoreceptor agonist

• usefull in sedation, analgesia, pre-anaesthesia

• the effects and clinical response are dose dependent

• for accurate microdosing and post-op sedation use Dexdomitor

0,1 mg/ml

• dexmedetomidine decreses an inhalant requirements

• remember about safety of your anaesthetised patients!

Robert Kraczkowski, DVM

 robert.kraczkowski@icloud.com

THANK YOU!

Robert Kraczkowski, DVM