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

## TL;DR

A nasal spray of dexmedetomidine effectively managed high-activity postoperative delirium in a patient, offering a new treatment option.

## Contribution

This case report introduces dexmedetomidine nasal spray as a novel treatment for acute high-active postoperative delirium.

## Key findings

- Dexmedetomidine nasal spray resolved symptoms of high-activity delirium rapidly and safely.
- The treatment preserved respiratory stability and hemodynamic balance.
- It modulates the locus coeruleus-noradrenergic pathway, mimicking natural sleep patterns.

## 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.