Does Dexmedetomidine (Dex) inhibit cerebrovascular spasms after brain surgery?
The precise action of Dex on the cerebral vasculature following subarachnoid hemorrhage is unknown. Dex appears to be a cerebral vasoconstrictor. [iv], [v] This action may occur as a result of Dex’s action on alpha-2 receptors within cerebral blood vessels, without the mitigating vasodilating influence that predominates on blood vessels outside of the central nervous system. Although clinical studies have not yet been performed, there is no evidence that Dex’s cerebral vasoconstriction leads to inadequate brain perfusion. [vi] Several anecdotal reports have indicated that Dex can be used safely and effectively as a sedative following subarachnoid hemorrhage in cases where vasospasm was documented prior to Dex initiation.
