Profound reduction in sedation and analgesic requirments using extended dexmedetomidine infusions in a patient with an open abdomen

Scoff Wallace, Brian Mecklenburg, Steven Hanling

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9 Scopus citations

Abstract

We present a 20-year-old previously healthy male who suffered a gunshot wound to the abdomen and underwent multiple surgeries because of abdominal abscess and fistula formation. Pain control was difficult to achieve despite high-dose opioid therapy. Post-traumatic stress disorder was a confounding factor in treating this patient's pain. Ten months after the original injury, the patient returned to the operating room for an exploratory laparotomy with restoration of bowel continuity and abdominal wall closure. The patient presented to the intensive care unit after a 12-hour operation with an open abdomen and the requirement of mechanical ventilation, sedation, and analgesia. Sedation and analgesia were difficult to achieve and maintain with combinations of extremely high doses of midazolam, lorazepam, propofol, and fentanyl (motor assessment activity scale [MAAS] scores of 5), but profoundly achievable with dexmedetomidine. Dexmedetomidine also improved the patient's mental stability, which resulted in improved patient care through compliance with physicians, nurses, and physical therapists.

Original languageEnglish (US)
Pages (from-to)1228-1230
Number of pages3
JournalMilitary medicine
Volume174
Issue number11
DOIs
Publication statusPublished - Nov 2009

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ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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