Un mecanismo nefrogénico subyace a la poliuria inducida por dexmedetomidina: informe de un caso

Abstract

Dexmedetomidine's α-adrenoreceptor agonism has been gaining popularity in the anesthetic room as a sedative-hypnotic and analgesic agent, and with extensive perioperative use rising concern about side effects is necessary.

Bradycardia and hypotension are common but excessive urine output is increasingly reported, suggested mechanisms being vasopressin secretion and increasing permeability of the collecting ducts.

Polyuria usually resolves with discontinuation of the drug and significant morbidity has not been reported. Early identification, removal of agent and treatment are imperative to minimize complications, mainly associated with natremia levels and neurological symptoms.

This case report describes a dexmedetomidine-related polyuric syndrome during opioid-free general anesthesia for major head and neck surgery. A nephrogenic mechanism for the clinical effect is proposed and reinforced by analytical data obtained. An intra-operative polyuria approach is also delineated.