title: Analgesic effect of dexmedetomidine in a patient with herpetic stomatitis after living-donor lung transplantation.
abstract: A 31-year-old woman suffering from bronchiolitis obliterans received bilateral living-donor lung transplantation to treat end-stage respiratory failure. After 5 days' mechanical ventilation, the patient was successfully extubated. During mechanical ventilation, the patient was sedated with a continuous intravenous infusion of propofol and dexmedetomidine (DEX). To assuage postoperative pain, morphine was infused, first intravenously, then epidurally. The administration of DEX was continued after extubation to prevent agitation. After the administration of epidural morphine was discontinued on day 10 in the intensive care unit (ICU), the patient complained of pain in the oral cavity. Greater pain was reported after the discontinuation of DEX, and symptoms of tachycardia and dyspnea appeared. A dermatologist diagnosed the oral symptoms as herpetic stomatitis, and a course of treatment with aciclovir was begun. A continuous infusion of DEX was again started on the same day, and was continued until ICU day 13. During the administration of DEX, the oral cavity pain was bearable. The patient was successfully discharged from the ICU on ICU day 13. We conclude that DEX could be used to provide analgesia for herpetic stomatitis after living-donor lung transplantation, at a dosage that achieves appropriate sedation.
authors.affiliation: Intensive Care Unit, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Ohta
authors.forename: Osamu
authors.initials: O
authors.lastname: Hirao
authors.forename: Akinori
authors.initials: A
authors.lastname: Uchiyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Mashimo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fujino
mesh_terms: D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D019520:Living Donors; D016040:Lung Transplantation; D010146:Pain / Q000188:drug therapy; D013283:Stomatitis, Herpetic / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D020927:Dexmedetomidine