Check out the timestamps below to help you navigate through the many topics we discussed.
On This Episode:
Dexmedetomidine — or “Dex” — has become one of the most intriguing and versatile drugs in the anesthesia world. In this episode of Anesthesia Alchemy with hosts Lynn Macksey, MSN, CRNA and Garry Brydges, PhD, DNP, MBA, CRNA, ACNP-BC, FAAN dive deep into the pharmacology, clinical application, and emerging research surrounding this alpha-2 agonist.
From its receptor-level effects in the CNS to new oral mucosal delivery systems and potential use in cancer care, Dex is proving to be far more than just a sedative. You'll hear practical takeaways for CRNAs using Dex in general, spinal, and regional anesthesia, plus its anti-inflammatory, neuroprotective, and even immunomodulating properties. Whether you're administering it IV, buccal, or as part of a multimodal pain strategy, get evidence-based insight to use Dex more confidently and effectively in your daily practice.
Here’s some of what we discuss in this episode:
🧠 CNS receptor action and sedative pathways
💉 IV, buccal, spinal, and local delivery methods
🫁 Organ protection and anti-inflammatory effects
🛏️ Potential future use as a sleep aid
🧬 Promising research on cancer immunity and stress modulation
Will you be among the Congress attendees tackling some of today's most urgent challenges in nurse anesthesiology?
Join nurse innovator and Hackathon host Rebecca Love, RN, MSN, FIEL, along with former AANA president and Beyond the Mask podcast host Sharon Pearce, DNP, CRNA, FAANA, FAAN, and 14 expert CRNA/nurse anesthesiologist mentors for an exclusive opportunity to collaborate, compete, and create real-world solutions.
This team-based, high-energy event is free to attend — but space is limited. Only 112 seats are available. Save your seat at aana.com/hackathon.
Important Links:
"It's fascinating to see how our understanding of dexmedetomidine continues to expand as we move forward."
- Lynn & Garry
References
Carnet Le Provost, K., Kepp, O., Kroemer, G., & Bezu, L. (2024). Trial watch: dexmedetomidine in cancer therapy. Oncoimmunology, 13(1), 2327143–2327143. https://doi.org/10.1080/2162402X.2024.2327143
Chen, X., Chen, Q., Qin, Z., Alam, A., Zhao, H., West, R., Liu, X., Li, J., Li, X., Yi, B., Ma, D., & Gu, J. (2025). Dexmedetomidine Attenuates Inflammation in Elderly Patients Following Major Hepatobiliary and Pancreatic Surgery: A Randomized Clinical Trial [Corrigendum]. Clinical Interventions in Aging, 20, 81–82. https://doi.org/10.2147/CIA.S516385
Gao, X., & Wu, Y. (2024). Perioperative acute kidney injury: The renoprotective effect and mechanism of dexmedetomidine. Biochemical and Biophysical Research Communications, 695, 149402-. https://doi.org/10.1016/j.bbrc.2023.149402
Liu, J., Yang, J., Yang, X., Yin, G., Li, T., Li, R., & Wang, A. (2024). Application of dexmedetomidine combined with propofol-etomidate mixture in radical gastrectomy under general anesthesia. Medicine (Baltimore), 103(44), e39669-. https://doi.org/10.1097/MD.0000000000039669
Krishna, A. S., Agarwal, J., Khanuja, S., Kumar, S., Khan, A., & Butt, K. M. (2024). Comparison of intravenous dexmedetomidine versus ketamine-dexmedetomidine combination on spinal block characteristics in patients undergoing lower limb orthopaedic surgery - A randomised clinical trial. Indian Journal of Anaesthesia, 68(9), 795–800. https://doi.org/10.4103/ija.ija_14_24
Peitl, V., & Vlahović, D. (2024). Dexmedetomidine. Archives of Psychiatry Research, 60(3), 251–253. https://doi.org/10.20471/sept.2024.60.03.09
Salahudheen, A., Haidry, N., Ahmad, S., Choudhary, S., Mokhtar, E. A., & Shivhare, P. (2024). Efficacy of Pre-emptive Infiltration of Dexmedetomidine with a Local Anaesthetic on Postoperative Pain in Maxillofacial Trauma Management under General Anaesthesia: A Prospective Study. Annals of Maxillofacial Surgery, 14(1), 33–39. https://doi.org/10.4103/ams.ams_225_23
Schnider, L. K., Ratajczak, M., Wespi, R., Kientsch, J. G., Bavato, F., Marten, L., Kost, J., Puchkov, M., Eicher, C., Boxler, M., Voegel, C. D., Bosch, O. G., van Someren, E., Dornbierer, D. A., & Landolt, H.-P. (2025). Effects of Subanesthetic Oromucosal Dexmedetomidine on Sleep in Humans: A Randomized, Controlled Pharmacokinetics-Pharmacodynamics Study. Anesthesiology (Philadelphia), 142(3), 476–487. https://doi.org/10.1097/ALN.0000000000005314
Wang, T., Pan, R., Wen, J., & Ma, X. (2025). Dexmedetomidine modulates peritoneal macrophage to attenuate lipopolysaccharide-induced inflammation. Cellular Immunology, 411–412, 104942-. https://doi.org/10.1016/j.cellimm.2025.104942
Yao, X., Liu, Y., Sui, Y., Zheng, M., Zhu, L., Li, Q., Irwin, M. G., Yang, L., Zhan, Q., & Xiao, J. (2024). Dexmedetomidine facilitates autophagic flux to promote liver regeneration by suppressing GSK3β activity in mouse partial hepatectomy. Biomedicine & Pharmacotherapy, 177, 117038-. https://doi.org/10.1016/j.biopha.2024.117038
Yin, J., Cao, S., Lei, J., Wang, X.-Y., You, J.-P., Xu, D.-C., Chen, X.-D., & Xu, W.-P. (2024). Dose-response of epidural ropivacaine with 0.4 μg mL-1 of dexmedetomidine for labor analgesia: A prospective double-blinded study. Medicine (Baltimore), 103(38), e39654-. https://doi.org/10.1097/MD.0000000000039654
Zhang, C., Qu, Y., Cao, Q., Tao, Y., Huai, X., Xuan, W., Pan, Z., Wang, X., & Tian, J. (2025). Effect of intraoperative dexmedetomidine on prognosis in patients with cancer undergoing surgical procedures: a systematic review and meta-analysis. British Journal of Anaesthesia : BJA. https://doi.org/10.1016/j.bja.2025.02.041
Zhou, Y., Bai, Z., Zhang, W., Xu, S., Feng, Y., Li, Q., Li, L., Ping, A., Chen, L., Wang, S., & Duan, K. (2024). Effect of Dexmedetomidine on Postpartum Depression in Women With Prenatal Depression: A Randomized Clinical Trial. JAMA Network Open, 7(1), e2353252-. https://doi.org/10.1001/jamanetworkopen.2023.53252
