Intranasal dexmedetomidine: Procedural sedation in palliative care: A case report

Abstract

Background: This report describes the use of intranasal dexmedetomidine to control incident pain and facilitate daily change of dressing in a patient with cutaneous breast cancer. Case presentation: A 45-year-old woman with extensive thoracic cutaneous metastatic bilateral breast cancer requiring daily 2-hour dressing changes to manage significant exudate. Pain during change of dressing was severe and unresponsive to usual analgesics. Deeper sedation was not an option as the patient was required to change position 1 hour into dressing change. Case management: Intranasal dexmedetomidine was administered 40 minutes prior to dressing change and provided effective rousable sedation and analgesia for the duration of the procedure. Case outcome: Dexmedetomidine provided rousable sedation, allowing the patient to follow commands and mobilise during the procedure. Pain was controlled. No adverse cardiovascular effects were noted with the use of intranasal dexmedetomidine. Conclusion: Intranasal dexmedetomidine is a potentially useful medication for procedural sedation in the management of complex wound dressings. It provides rousable short-term sedation, anxiolysis and analgesia. Further research into the role of intranasal dexmedetomidine to facilitate challenging dressing changes in a community setting is warranted.

Providing holistic care to children with cerebral palsy treated with transnasal neural stem cell transplantation

“…Treatment procedures, such as the placement of the NSC patch through the nasal cavity, cause anxiety and pain and lead to violent resistance and difficulty cooperating with the treatment. Some studies have shown that moderate sedation and sleep deprivation can effectively ensure the accuracy of examination results without motion imaging and smooth treatment progress (31,32). The nurses in this study used phenobarbital, chloral hydrate, and other drugs to sedate the children gradually, according to the doctor's advice, and closely observed the status of the children during the sedation period.…”

Intranasal Dexmedetomidine for Pain Management in Older Patients: A Cross-Over, Randomized, Double-Blinded, Active-Controlled Trial

“…The adequate dose of IN DEX to be administered was a challenging choice. One case report suggested that both 1 and 1.5 µg/kg of IN DEX were safe and effective to induce light sedation in the management of complex wound dressings for cutaneous thoracic metastatic bilateral breast cancer in a 45-year-old woman [ 39 ]. The recommended doses of IN DEX varied from 0.5 to 1.5 µg/kg for adults, while the doses commonly reported in children varied from 0.5 to 4 µg/kg [ 13 , 15 , 20 , 23 – 25 , 40 , 41 ].…”