Dexmedetomidine is approved for sedation in adult intensive care patients, and is increasingly used off-label in paediatric patients to prevent agitation: as premedication in the form of intranasal, buccal and oral solution, as an adjunct for elective surgery; as a sedative for magnetic resonance imaging; as intraoperative analgesia; for extracorporeal shock wave lithotripsy; as an adjuvant for nerve blocks; and intravenously in intensive care units with the purpose of sedation of children. [6] Compared with clonidine (an α2-agonist that has been used for several decades), dexmedetomidine has a greater selectivity for α2-receptors (α2: α1 ratio of 1620:1 vs. 220:1). As central α1-adrenoceptor activation counteracts the sedative α2 effects, dexmedetomidine is a more potent sedative than clonidine.
