Use of Dexmedetomidine for the Management of Excited Delirium in a Polysubstance Dependence Trauma Patient

Use of Dexmedetomidine for the Management of Excited Delirium in a Polysubstance Dependence Trauma Patient

Management of acute delirium in patients with polysubstance dependence remains a challenge due to the overlap in symptoms between the delirium and the withdrawal syndromes from multiple agents. We describe a recent case of a trauma patient after a motor vehicle accident with polysubstance dependence including opioids, benzodiazepines and cocaine. The patient developed acute agitated delirium, requiring mechanical ventilation for respiratory insufficency. His delirium was treated with haloperidol and lorazepam, but to facilitate rapid control and possible prevention of a withdrawal syndrome we used dexmedetomidine in the acute phase. The early use of dexmedetomidine may facilitate a safe and effective treatment modality in agitated delirium as well as a possible preventive measure in controlling any severe withdrawal syndrome.