Intranasal Dexmedetomidine as a rescue strategy for established postoperative delirium following loss of intravenous access: a case report - Scorecard - MDSpire

Intranasal Dexmedetomidine as a rescue strategy for established postoperative delirium following loss of intravenous access: a case report

  • By

  • Yingao Peng

  • Mingjin Liu

  • Jiafang Wang

  • July 7, 2026

  • 0 min

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Clinical Scorecard: Use of Intranasal Dexmedetomidine as an Alternative Intervention for Postoperative Delirium After Loss of IV Access: A Case Study

At a Glance

CategoryDetail
ConditionPostoperative Delirium (POD)
Key MechanismsIntranasal delivery of dexmedetomidine to manage agitation and delirium.
Target PopulationElderly surgical patients, particularly those with risk factors for delirium.
Care SettingPostoperative care in a surgical ward.

Key Highlights

  • Intranasal dexmedetomidine provided rapid sedation in a patient with POD.
  • The patient transitioned from agitation to calm within 1 hour of administration.
  • Mild bradycardia was the only hemodynamic alteration observed.
  • The Confusion Assessment Method (CAM) test was negative on postoperative day 2.
  • The patient was discharged uneventfully on postoperative day 4.

Guideline-Based Recommendations

Diagnosis

  • POD diagnosed according to DSM-5 criteria.

Management

  • Use of intranasal dexmedetomidine as a non-invasive rescue option for POD.

Monitoring & Follow-up

  • Monitor vital signs and mental status post-administration.

Risks

  • Potential for mild bradycardia and need for monitoring of respiratory function.

Patient & Prescribing Data

Elderly male with multiple risk factors for POD.

Dexmedetomidine administered in a stepwise titration protocol (total dose: 100 μg).

Clinical Best Practices

  • Consider non-invasive alternatives for managing POD when IV access is lost.
  • Monitor for hemodynamic stability and mental status improvement post-treatment.

Related Resources & Content

    Original Source(s)

    Intranasal Dexmedetomidine as a rescue strategy for established postoperative delirium following loss of intravenous access: a case report

    • by Yingao Peng, Mingjin Liu, Jiafang Wang

    • July 7, 2026

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