PDF herunterladen
CC BY 4.0 · J Neuroanaesth Crit Care
DOI: 10.1055/s-0044-1791687
Case Report

Intranasal Dexmedetomidine for Sedation in Acute Ischemic Stroke: A Case Report

Antonio Romanelli 
1   Department of Anaesthesia and Intensive Care, A.O.U. “San Giovanni di Dio e Ruggi d'Aragona”, Salerno, Italy
,
Antonella Langone
1   Department of Anaesthesia and Intensive Care, A.O.U. “San Giovanni di Dio e Ruggi d'Aragona”, Salerno, Italy
,
Flora Minichino
1   Department of Anaesthesia and Intensive Care, A.O.U. “San Giovanni di Dio e Ruggi d'Aragona”, Salerno, Italy
,
Renato Gammaldi
1   Department of Anaesthesia and Intensive Care, A.O.U. “San Giovanni di Dio e Ruggi d'Aragona”, Salerno, Italy
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

This case report presents the innovative use of intranasal dexmedetomidine (IN-DEX) for sedation in an 82-year-old female patient undergoing endovascular treatment (EVT) for acute ischemic stroke (AIS). The patient, with a history of chronic atrial fibrillation, arterial hypertension, and chronic kidney failure, presented with sudden left-sided weakness. IN-DEX was administered to manage her agitation, achieving stable sedation without respiratory depression, facilitating EVT, and preserving the patient's cooperative state for accurate neurological assessments. The procedure was completed successfully, with stable vital parameters and no complications. This report highlights IN-DEX's potential as a noninvasive, effective sedative alternative in emergency neurological settings, emphasizing its advantages in maintaining respiratory function and reducing stress responses in AIS patients. Further studies are recommended to validate these findings and explore the broader applicability of IN-DEX in AIS management.

Keywords

dexmedetomidine - intranasal administration - acute ischemic stroke - endovascular treatment - sedation


Publikationsverlauf

Artikel online veröffentlicht:
04. Dezember 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Patel A, Davidson M, Tran MC. et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy. Anesth Analg 2010; 111 (04) 1004-1010
    CrossrefPubMedSuche in Google Scholar
  • 2 Bao N, Tang B. Organ-protective effects and the underlying mechanism of dexmedetomidine. Mediators Inflamm 2020; 2020: 6136105
    PubMedSuche in Google Scholar
  • 3 Nii K, Hanada H, Hiraoka F, Eto A, Mitsutake T, Tsutsumi M. Usefulness of consciousness sedation with dexmedetomidine and pentazocine during endovascular treatment for acute stroke. Neurol Med Chir (Tokyo) 2018; 58 (02) 79-84
    CrossrefPubMedSuche in Google Scholar
  • 4 Zhang G, Xin L, Yin Q. Intranasal dexmedetomidine vs. oral midazolam for premedication in children: a systematic review and meta-analysis. Front Pediatr 2023; 11: 1264081
    CrossrefPubMedSuche in Google Scholar
  • 5 Terceño M, Silva Y, Bashir S. et al; Catalan Stroke Code and Reperfusion Consortium (Cat-SCR). Impact of general anesthesia on posterior circulation large vessel occlusions after endovascular thrombectomy. Int J Stroke 2021; 16 (07) 792-797
    CrossrefPubMedSuche in Google Scholar
  • 6 Li BL, Guan YP, Yuen VM. et al. Population pharmacokinetics of intranasal dexmedetomidine in infants and young children. Anesthesiology 2022; 137 (02) 163-175
    CrossrefPubMedSuche in Google Scholar
  • 7 Crowe TP, Hsu WH. Evaluation of recent intranasal drug delivery systems to the central nervous system. Pharmaceutics 2022; 14 (03) 629
    CrossrefPubMedSuche in Google Scholar
  • 8 Dhuria SV, Hanson LR, Frey II WH. Intranasal delivery to the central nervous system: mechanisms and experimental considerations. J Pharm Sci 2010; 99 (04) 1654-1673
    CrossrefPubMedSuche in Google Scholar
  • 9 Gong M, Man Y, Fu Q. Incidence of bradycardia in pediatric patients receiving dexmedetomidine anesthesia: a meta-analysis. Int J Clin Pharm 2017; 39 (01) 139-147
    CrossrefPubMedSuche in Google Scholar
  • 10 Marra P, Di Stadio A, Colacurcio V. et al. Sedation with intranasal dexmedetomidine in the pediatric population for auditory brainstem response testing: review of the existing literature. Healthcare (Basel) 2022; 10 (02) 287
    CrossrefPubMedSuche in Google Scholar