This case suggests that IN dexmedetomidine may offer a safe, non-invasive rescue option for established postoperative delirium when IV access is unavailable.
Abstract
The clinical management of established postoperative delirium (POD) is particularly challenging in patients who exhibit agitated behavior and self-remove intravenous (IV) access. A 70-year-old man with prior cerebral infarction developed POD following urologic surgery under general anesthesia. Two doses of IV diazepam failed to provide sustained relief, and the patient subsequently self-removed his IV catheter. Intranasal (IN) dexmedetomidine was administered in a stepwise titration protocol (total dose: 100 μg). The patient transitioned from agitation to calm and entered sustained sleep within 1 h. The only hemodynamic alteration observed was mild bradycardia (heart rate: 58–65 beats/min), with no clinically significant respiratory depression occurring throughout the observation period. The Confusion Assessment Method (CAM) test result was negative on postoperative day 2, and the patient was discharged uneventfully on postoperative day 4. This case suggests that IN dexmedetomidine may offer a safe, non-invasive rescue option for established POD when IV access is unavailable.
STUDY OBJECTIVES
Adolescents with severe agitation may require repeated administration of sedatives. We describe dexmedetomidine infusion as a novel bridge therapy for selected agitated adolescents awaiting psychiatric treatment and disposition.
METHODS
We retrospectively studied adolescents (12 to 17 years) treated...
Giorgio Cozzi, Alessandro Zago, A. Di Mascio et al.· Annals of Emergency Medicine· 1 citation
BACKGROUND
Combination propofol-dexmedetomidine (DEX) therapy may affect patient prognosis. However, it remains unknown whether the effects of this combination depend on the timing of DEX initiation.
OBJECTIVE
This study aimed to investigate the association between early initiation of DEX and mortality in mechanicall...
Bo-Zhi Zhang, M. Liao, Han-Bing Wang· The Annals of Pharmacotherap...· 0 citations
Asplenia syndrome is a rare congenital abnormality associated with a nonfunctional or no spleen, cardiac defects, and abdominal organ malpositioning. This report describes an 11-year-old boy diagnosed with asplenia syndrome and pulmonary hypertension who underwent intravenous (IV) moderate sedation for dental treatment...
Eriko Sato, Mao Shinohara, Ayaka Ikariyama et al.· Anesthesia Progress· 0 citations
Aim/Objective: Dexmedetomidine (DEX), a highly selective α2-adrenoceptor agonist, has sedative, analgesic, anxiolytic, and immunomodulatory properties that may provide benefits in critically ill patients with COVID-19. This study aimed to evaluate the effect of DEX on clinical outcomes in patients with severe COVID-19...
Kubilay Işsever, A. Genç, A. C. Genç et al.· Cukurova Anestezi ve Cerrahi...· 0 citations
PURPOSE
This article describes methods of reducing emergence delirium, and subsequently narcotic administration, in the post-anesthesia care unit (PACU) using an intraoperative dexmedetomidine bolus and evidence-based education bundles.
DESIGN
Quality improvement (QI) project including retrospective data analysis and...
J. Hamilton, Katie Gostomski, W. Pflueger et al.· Journal of Perianesthesia Nu...· 0 citations
Objective: To evaluate the efficacy of intranasal dexmedetomidine for postoperative analgesia in geriatric patients undergoing lower limb orthopaedic surgeries, with postoperative pain scores as primary outcome and haemodynamic stability and sedation as secondary outcome during the first 24 h.
Methods: This prospective...
U. A. Reddy, Renuka Holyachi, Santoshkumar Karjagi et al.· International Journal of Cur...· 0 citations
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