MINI REVIEW article
Front. Pharmacol.
Sec. Neuropharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1702862
Dexmedetomidine for Postoperative Delirium in Surgical Patients: A Mini-Review of Mechanisms, Clinical Evidence, and Practical Implementation
Provisionally accepted
- The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
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ABSTRACT Postoperative delirium (POD) is a common acute neurocognitive disorder in the perioperative period, significantly increasing the risks of mortality and long-term functional decline. Dexmedetomidine, a highly selective α2-adrenergic receptor agonist, demonstrates potential for POD prevention through multimodal mechanisms, including sympatholytic effects, neuroinflammation attenuation, and physiological sleep preservation. Clinical evidence indicates its efficacy in reducing delirium incidence in cardiac surgery (risk ratio (RR), 0.57) and elderly non-cardiac surgical patients (RR, 0.51), though with notable population heterogeneity and risks of adverse effects such as bradycardia. Current guidelines recommend a dosing range of 0.1–0.7 μg/kg/h, yet monitoring requirements (e.g., electroencephalogram vs. hemodynamics) vary regionally. Future research should focus on precision dosing (e.g., biomarker-guided approaches), next-generation α2-agonists, and optimized multimodal strategies. The clinical application of dexmedetomidine requires careful risk-benefit assessment and integration into individualized perioperative protocols. Key words: Postoperative delirium; dexmedetomidine; clinical application; management; perspective.
Keywords: postoperative delirium, Dexmedetomidine, clinical application, Management, perspective
Received: 10 Sep 2025; Accepted: 02 Oct 2025.
Copyright: © 2025 Li, Yang, Qiu, Wang and Wang. 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: Xiao-dong Wang, xiao-dongwang@hotmail.com
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