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This article provides the data on the use of dexmedetomidine in anesthesiology and critical care medicine, as well as a brief review of its pharmacological properties and its aspects in neuroanesthesiology. Dexmedetomidine, as a selective a2A-adrenoagonist, is used in a variety of clinical situations, but neurosurgery is the area where the potential of the drug can be fully realized. During neurosurgery, it is extremely important to ensure stable hemodynamics, to avoid sudden rise of heart rate and blood pressure, as well as to make neurological examination as soon as possible for the earliest assess of the result of a surgery, and making extubation safe for the patient, by avoiding the reaction to the intubation tube and risk of depression of spontaneous breathing. In addition, there are specific neurosurgical operations, for the safe and efficient conduct of which requires intraoperative neurological examination, which might be provided by the unique properties of dexmedetomidine.

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