title: [Apnea and severe respiratory depression induced by dexmedetomidine after general anesthesia in intensive care unit].
abstract: Dexmedetomidine (DEX) is widely used in intensive care unit for perioperative sedation. The one advantage of DEX administration for sedation is the lack of significant respiratory depression. However, DEX shows significant interaction with anesthetics and narcotics, and we present a case in which post-anesthetic administration of DEX induced apnea and severe respiratory depression after extubation. A 74-year-old, 38.3 kg, 148 cm woman was scheduled to undergo implantation of internal cardiac defibrillator. General anesthesia was maintained by sevoflurane, remifentanil and intermittent administration of fentanyl. After the surgery, she was transferred to intensive care unit with intubation, and DEX administration was commenced. After 3.5 hr from the end of anesthesia, the patient's trachea was extubated under continuous infusion of DEX (0.26 microg x kg(-1) x hr(-1)). Ninety min later, she showed apnea and severe respiratory depression. The interaction of DEX and residual narcotics might have induced life-threatening respiratory complication.
authors.affiliation: Intensive Care Unit of University Hospital, Hamamatsu University School of Medicine, Hamamatsu 431-3192.
authors.forename: Taiga
authors.initials: T
authors.lastname: Itagaki
authors.forename: Sakiko
authors.initials: S
authors.lastname: Uchisaki
authors.forename: Yushi
authors.initials: Y
authors.lastname: Adachi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Suzuki
authors.forename: Yukako
authors.initials: Y
authors.lastname: Obata
authors.forename: Matsuyuki
authors.initials: M
authors.lastname: Doi
authors.forename: Shigehito
authors.initials: S
authors.lastname: Sato
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D000777:Anesthetics / Q000009:adverse effects; D001049:Apnea / Q000139:chemically induced*; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000009:adverse effects*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D007362:Intensive Care Units; D009294:Narcotics / Q000009:adverse effects; D011182:Postoperative Care; D012131:Respiratory Insufficiency / Q000139:chemically induced*; D012720:Severity of Illness Index
chemical_list: D000777:Anesthetics; D006993:Hypnotics and Sedatives; D009294:Narcotics; D020927:Dexmedetomidine