#36092 Dexmedetomidine in palliative care

Abstract

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Background and Aims

Delirium is common in the terminal patient. It increases discomfort for the patient and relatives. The agents used totreat delirium are various antipsychotics, which are not always effective. Dexmedetomidine intranazal application was effective.

Methods

A case report of a palliative patient who developed a severe dellirium well treated by the dexmedetomidine.

Results

A 42-year-old cancer patient was developed a severe dellirium. Delirium did not subside with the antipsychotics. Dexmedetomidine intranazal application 1 mcg/kg. The patient became completely calm and his previous neuroleptic and sedation therapy could be withdrawn. In the following days, he reacted sensibly and responded to instructions, his day-night rhythm was restored.

Conclusions

Palliative care is becoming an important area of medicine in where also anaesthesiologists participate. With our knowledge and experience, we can contribute a lot to better treatment of pain, as well as other conditions such as delirium and the need for patient sedation. In order to treat patients well, it is important to be familiar with medications and techniques, soit is important to apply our knowledge from operating theatres and ICUs to palliative care. Dexmedetomidine is a potentially useful drug for the targeted treatment of pain and delirium inthe tertiary palliative care setting. When used for sedation and delirium treatment, dexmedetomidine fits with the patient’s, family’s and physician’s goals of care when patient alertness and participation in conversations with loved ones and healhealth care personnel are important at the end of life.