{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:34:46Z","timestamp":1788870886494,"version":"build-2803163510"},"reference-count":55,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T00:00:00Z","timestamp":1743292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Newborns, including preterm infants, are capable of responding to pain. Recurrent pain exposure is associated with suboptimal motor development, cognitive impairments, abnormal brain growth, and maladapted nociceptive reactions. Problem: Current agents, primarily opioids and benzodiazepines, raise major concerns due to their adverse effects, including insufficient sedation or analgesia, withdrawal, depressed respiratory effort, tolerance, and occasional paradoxical agitation. Commonly used drugs such as midazolam and morphine have been shown to induce neuroapoptosis and neurodevelopmental abnormalities in animal studies. Evaluation\u2014Dexmedetomidine: As a specific alpha-2 adrenergic agonist, dexmedetomidine causes a significantly lower reduction in breathing effort. It has over 800 times greater affinity for alpha-2 receptors compared to alpha-1 receptors. Common side effects include bradycardia and hypotension. Prolonged use may necessitate a transition to clonidine during the weaning process. Dexmedetomidine can be administered intravenously as a bolus or infusion or intranasally. Indications include sedation and analgesia for mechanical ventilation, therapeutic hypothermia, procedural premedication, and as an adjunct to inhalational anesthesia and nerve-blocking agents. Research across varying age groups has demonstrated that dexmedetomidine shortens periods of invasive ventilation and decreases the need for other sedatives. Neonatal studies suggest that dexmedetomidine may help accelerate the achievement of full enteral feeds and can be safely administered within specific dosage ranges without causing significant adverse events that would necessitate abrupt discontinuation. Conclusions: Dexmedetomidine can be used alone or in combination with other agents. By increasing the use of dexmedetomidine, it is possible to reduce the dosage of concurrent medications, thereby minimizing the risk of complications while still achieving the desired sedation and analgesia.<\/jats:p>","DOI":"10.3390\/children12040444","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T05:21:04Z","timestamp":1743398464000},"page":"444","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Dexmedetomidine: Shifting Paradigms in Neonatal Sedation and Pain Control"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3857-8663","authenticated-orcid":false,"given":"Kok Joo","family":"Chan","sequence":"first","affiliation":[{"name":"Newborn Care Centre, Royal Hospital for Women, Sydney, NSW 2031, Australia"},{"name":"Discipline of Paediatrics & Child Health, University of New South Wales, Sydney, NSW 2031, Australia"},{"name":"Neonatology Unit, Department of Pediatrics, University of Malaya Medical Centre, Kuala Lumpur 59100, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivas","family":"Bolisetty","sequence":"additional","affiliation":[{"name":"Newborn Care Centre, Royal Hospital for Women, Sydney, NSW 2031, Australia"},{"name":"Discipline of Paediatrics & Child Health, University of New South Wales, Sydney, NSW 2031, Australia"},{"name":"Medical Co-Director of Newborn Care, Royal Hospital for Women, Sydney, NSW 2031, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/S2213-2600(15)00331-8","article-title":"Sedation and analgesia practices in neonatal intensive care units (EUROPAIN): Results from a prospective cohort study","volume":"3","author":"Carbajal","year":"2015","journal-title":"Lancet Respir. 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