• Mikiko Ohtsuka.
• Department of Anesthesia, Jujo Rehabilitation Hospital, Kyoto 601-8325.
• Masui. 2012 Apr 1;61(4):379-83.

BackgroundDexmedetomidine (DEX) has analgesic, anxiolytic, and antidelirium effects, and causes little respiratory depression. Behavioral disturbances such as agitation, aggression, and sleep disorder are common in cognitive impairment; this impairment may be one of the risk factors for postoperative delirium. We studied the effects of postoperative DEX administration in elderly patients with cognitive impairment.MethodsTen patients with cognitive impairment, aged 70 to 90 years, were maintained under both general and local anesthesia. We administered DEX (0.2-0.4 microg x kg(-1) x hr(-1)) to these patients 30 to 60 min before the end of the operation. The dose of DEX was reduced to 0.1-0.2 microg x kg(-1) hr(-1) by the time of extubation, and was increased in incremental doses 0.1 microg x kg(-1) x hr(-1) depending on postoperative agitation.ResultsSeven of 10 patients were calm; however, in 3 patients, the dose had to be increased by 0.1 microg x kg(-1) x hr(-1). No serious complication was observed, except bradycardia in 2 patients.ConclusionsLow-dose DEX is safe and useful for postoperative sedation in elderly patients with cognitive impairment.

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