Dexmedetomidine Overdose in the Perioperative Setting

Victor S B Jorden, Robert M. Pousman, Mary M. Sanford, Per Thorborg, Michael Hutchens

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

OBJECTIVE: To report 3 cases of accidental dexmedetomidine overdose in the perioperative setting and review the pathophysiology of α 2-agonist overdose. CASE SUMMARIES: Three patients accidentally received overdoses of dexmedetomidine, one intraoperatively (192 μg over 20 min) and 2 postoperatively (4 and 2 rather than 0.4 and 0.2 μg/kg/h; 0.5 μg/kg/min rather than 0.5 μg/kg/h). Hemodynamic parameters remained stable for all 3 patients. The most notable sign was oversedation diagnosed either clinically or using a bispectral index monitor; Naranjo criteria suggest possible or probable association of the reactions with dexmedetomidine. In all 3 cases, oversedation resolved within one hour of drug discontinuation. There were no other sequelae, and the remainder of each patient's hospital course was unremarkable. DISCUSSION: As of this writing, dexmedetomidine dosing in excess of the label recommendation has been reported, but accidental dexmedetomidine overdose in clinical practice has not been described. Excessive levels of sedation were the only significant finding in all 3 patients. Dexmedetomidine's short redistribution half-life of 6 minutes should lead to rapid resolution of oversedation induced by overdoses if the overall duration of infusion is short (

Original languageEnglish (US)
Pages (from-to)803-807
Number of pages5
JournalAnnals of Pharmacotherapy
Volume38
Issue number5
DOIs
StatePublished - May 2004

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Dexmedetomidine
Consciousness Monitors
Half-Life
Hemodynamics
Pharmaceutical Preparations

Keywords

  • Dexmedetomidine
  • Overdose

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Jorden, V. S. B., Pousman, R. M., Sanford, M. M., Thorborg, P., & Hutchens, M. (2004). Dexmedetomidine Overdose in the Perioperative Setting. Annals of Pharmacotherapy, 38(5), 803-807. https://doi.org/10.1345/aph.1D376

Dexmedetomidine Overdose in the Perioperative Setting. / Jorden, Victor S B; Pousman, Robert M.; Sanford, Mary M.; Thorborg, Per; Hutchens, Michael.

In: Annals of Pharmacotherapy, Vol. 38, No. 5, 05.2004, p. 803-807.

Research output: Contribution to journalArticle

Jorden, VSB, Pousman, RM, Sanford, MM, Thorborg, P & Hutchens, M 2004, 'Dexmedetomidine Overdose in the Perioperative Setting', Annals of Pharmacotherapy, vol. 38, no. 5, pp. 803-807. https://doi.org/10.1345/aph.1D376
Jorden, Victor S B ; Pousman, Robert M. ; Sanford, Mary M. ; Thorborg, Per ; Hutchens, Michael. / Dexmedetomidine Overdose in the Perioperative Setting. In: Annals of Pharmacotherapy. 2004 ; Vol. 38, No. 5. pp. 803-807.
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