[Three successful cases of continuous dexmedetomidine infusion for the treatment of intractable delirium associated with cancer pain].
We report three cases of successful treatment of intractable delirium associated with cancer pain with continuous dexmedetomidine (DEX) infusion. Case 1 : An 83-year-old man receiving oral oxycodone for lung cancer pain developed delirium. He was resistant to haloperidol infusion, oral quetiapine, and opioid rotation. DEX infusion was administered at 0.4 microg kg-1 hr-1, and his delirium resolved. Case 2: A 50-year-old woman with cervical cancer of the uterus suffered from sepsis but could not take oral oxycodone. After continuous morphine infusion, she developed delirium. She was resistant to haloperidol infusion or injections of oxycodone for opioid rotation, but DEX infusion at 0.4 microg kg-1hr-1 led to disappearance of delirium symptoms. Case 3: A 71-year-old woman with advanced renal cancer was treated with epidural analgesia to alleviate cancer pain. She subsequently developed delirium but was resistant to haloperidol or chlorpromazine infusion. DEX infusion at 0.3 microg kg-1 hr-1 led to disappearance of delirium symptoms and orientation recovery. DEX infusion may be effective for the treatment of intractable delirium associated with cancer pain.
Department of Anesthesiology and Palliative Care Unit, Hyogo Cancer Center Akashi 673-8558.
Nobuyasu
N
Komasawa
Department of Anesthesiology and Palliative Care Unit, Hyogo Cancer Center Akashi 673-8558.
Yoshie
Y
Kimura
Department of Anesthesiology and Palliative Care Unit, Hyogo Cancer Center Akashi 673-8558.
Akio
A
Hato
Department of Anesthesiology and Palliative Care Unit, Hyogo Cancer Center Akashi 673-8558.
Junichi
J
Ikegaki
D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D003693:Delirium / Q000188:drug therapy* / Q000209:etiology*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology*; D010166:Palliative Care / Q000379:methods*; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D020927:Dexmedetomidine