AUTHOR=Liu Yujing , Chen Lin , Liu Qian , Li Peng 

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

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1600737

DOI=10.3389/fmed.2025.1600737

ISSN=2296-858X

ABSTRACT=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.