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Precedex and airway reflexes

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epidural man

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Does anyone know of any evidence that precedex decreases airway reflexes or maintains them?

Is a spontaneously breathing person on dexmetadomidine still have a completely protected airway?
 

VentdependenT

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Does anyone know of any evidence that precedex decreases airway reflexes or maintains them?

Is a spontaneously breathing person on dexmetadomidine still have a completely protected airway?

Do a physical exam. If pt can talk to you coherently, has cough n' gag reflex, and isn't gorked then yeah they can protect their airway.

Do I let people drink and eat while on precedex? Hell no.

Do I put non-intubated folks on precedex? Hell yeah. Do it all the time in the unit to have smooth transition from the vent to the nasal canula in fatties and especially in folks who I had to intubate for agitation purposes.

I put this friggen crack head who was trying to bite nurses on precedex a couple of days ago. I lit him up with 20mg of haldol then threw his *** on the precedex ggt at 1.2ucg/kg/hr. That showed him.
 

coprolalia

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I put this friggen crack head who was trying to bite nurses on precedex a couple of days ago. I lit him up with 20mg of haldol then threw his *** on the precedex ggt at 1.2ucg/kg/hr. That showed him.

Damn, dude. That's a hefty dose. Did you leave it there? Or, did you turn it down once his heart rate was 47 and his BP was 170/90?

:laugh:

-copro
 

VentdependenT

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I let him cook on it overnight. Its great for hemodynamics. He was tachen away at 120 with BP 170/110 during agitation (he's got an EF of 25% from all the htn, crack, n' ETOH). Slowed a bit with the Haldol. The precedex: HR 80 BP 110/50. Friggen rock solid dude. I'd run that precedex up to 5ucg/kg/hr if I had to.

Got psych involved today. They are putting him on 5mg zyprexa oral Q3H (thaz a $hitload of zyprexa) D/C all benzo's/haldol and they agreed with leaving him on precedex! Is there anything this drug can't do?
 

coprolalia

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Is there anything this drug can't do?

:laugh:

Yeah, just be careful with the hypertension. I was running it during a coiling, and it snuck up on me. I've probably done 30-40 anesthetics using Precedex as an adjunct, and that was the first time I'd seen it. And, it persisted until I shut it off. (It was a TIVA with Remi, Precedex, and the white stuff.)

-copro
 

VentdependenT

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:laugh:

Yeah, just be careful with the hypertension. I was running it during a coiling, and it snuck up on me. I've probably done 30-40 anesthetics using Precedex as an adjunct, and that was the first time I'd seen it. And, it persisted until I shut it off. (It was a TIVA with Remi, Precedex, and the white stuff.)

-copro

I've read about it happening during the loading dose but never had it happen to me. Yeah I just knocked on my faux-wood desk.
 
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