Dexmedetomidine is a selective alpha-2-recep-tor agonist, and has recently been approved for use as a sedative agent for cardiac patients in the intensive care unit. Although not well investigated in neurosurgical patients, its pharmacological profile suggests that it may be a useful sedative in this group of patients. When given as an infusion at 0.6 mg/kg/h, most patients are well sedated but arousable, with minimal respiratory depression. It causes cerebrovasocon-striction and should reduce ICP, although the reduction in CBF is not matched by reduction in cerebral metabolism. Our own studies show that autoregulation and CO2 reactivity are not affected by sedative doses of dexmedetomidine (unpublished data). In experimental ischemia it has been shown to reduce the number of damaged neurons in transient global ischemia in gerbils, and following focal cerebral ischemia in rats. The mechanism of action is thought to be via a reduction in norepinephrine release. Additionally, it appears to enhance the disposal of glutamine by oxidative metabolism in
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.