Subcutaneous Dexmedetomidine for Refractory Symptoms
Dexmedetomidine by subcutaneous infusion can safely improve refractory pain and agitated delirium in hospice patients while maintaining rousable sedation.
It may reduce reliance on high-dose opioids/benzodiazepines and, in some cases, postpone the need for palliative sedation therapy.
Evidence Rating Level: 2 (Good)
A retrospective single-centre chart review from a New Zealand hospice evaluated continuous subcutaneous dexmedetomidine for adults with refractory end-of-life symptoms, mainly cancer pain (92%) and agitated delirium (50%).
- Twenty-six infusions were given to 25 patients between 2019 and 2024.
- Dexmedetomidine was started after conventional opioids, benzodiazepines, or antipsychotics proved inadequate.
Dexmedetomidine was started at 0.
Author's summary: Dexmedetomidine improves refractory symptoms in hospice patients.
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