In a recent issue of the British Journal of Anaesthesia, Zuppa and colleagues reported a landmark pharmacokinetic analysis of the pharmacokinetics of dexmedetomidine in neonates and infants undergoing cardiopulmonary bypass. Although the use of dexmedetomidine in children is not approved by the US Food and Drug Administration, the favourable haemodynamic and ventilatory profile of dexmedetomidine, combined with its remarkable lack of emergence delirium, has resulted in the increasing use of dexmedetomidine in infants and children for procedural sedation and surgical anaesthesia. The increasing use of dexmedetomidine may also reflect consideration of animal studies suggesting that dexmedetomidine does not pose any increased risk to infants and children during the potentially vulnerable period of synaptogenesis.

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