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CASE REPORT article

Front. Med.

Sec. Intensive Care Medicine and Anesthesiology

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1600737

This article is part of the Research TopicCase Reports in Anesthesiology 2025View all articles

Dexmedetomidine nasal spray to treat high-activity postoperative delirium: a case report

Provisionally accepted
Yujing  LiuYujing Liu1,2Lin  ChenLin Chen1,2Qian  LiuQian Liu1,3Peng  LiPeng Li1,2*
  • 1Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
  • 2Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
  • 3Anesthesiology, Chengdu Wenjiang District People's Hospital, Chengdu, Sichuan Province, China

The final, formatted version of the article will be published soon.

High-activity postoperative delirium (POD) represents a prevalent neuropsychiatric complication during the perioperative period. Current clinical research predominantly focuses on preventive strategies, while effective pharmacological interventions remain limited, particularly for acute high-active subtypes. This case report demonstrates the successful use of dexmedetomidine nasal spray in managing acute high-active POD. The dexmedetomidine exerts its therapeutic effects through selective modulation of the locus coeruleus-noradrenergic pathway, providing physiological sedation resembling natural sleep architecture while preserving respiratory stability. It also exerts analgesic and anti-inflammatory effects. The nasal spray facilitated precise dosing with rapid symptom resolution and maintained hemodynamic stability. This novel approach offers a safe and effective way to manage acute high-active POD.

Keywords: Dexmedetomidine, Nasal spray, postoperative delirium, hyperactive delirium, Non-intravenous sedation

Received: 26 Mar 2025; Accepted: 18 Aug 2025.

Copyright: © 2025 Liu, Chen, Liu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Peng Li, Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China

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