Mechanism, Dose, and Administration of Dexmedetomidine in Managing Visceral Pain Associated With Surgery: A Narrative Review

Visceral pain is often refractory and debilitating. Effective therapy for visceral pain remains undetermined or even elusive. Recently, dexmedetomidine (DEX) has been found to be promising as an adjuvant in relieving visceral pain. DEX, a highly selective alpha-2 adrenoreceptor agonist, is increasingly used during the perioperative period. DEX induces sedation, analgesia, anxiolysis, sympathetic tone inhibition, and intestinal barrier protection. It has shown favorable analgesic effects in clinical and animal studies and is a useful adjuvant treatment for visceral pain. It can be delivered via intravenous injections, intraspinal administration, intraperitoneal spraying, or other routes, and it exerts antinociceptive effects on visceral pain. This article reviews the mechanisms, dose, and modes of administration of dexmedetomidine in managing visceral pain associated with surgery. Moreover, we highlight the clinical evidence of DEX on visceral pain therapy in recent years. We also address the various protocols and routes for using DEX in the treatment of visceral pain, aiming to provide a foundation and direction for clinical practice and basic research.