Fatal pulmonary aspiration during balanced sedation with dexmedetomidine and midazolam: A case report
10.17085/apm.2019.14.2.236
- Author:
Jeong Heon PARK
1
;
Sang Yun KIM
;
Min A KWON
Author Information
1. Department of Anesthesiology and Pain Medicine, Dankook University Hospital, Cheonan, Korea. mmauss73@gmail.com
- Publication Type:Case Report
- Keywords:
Conscious sedation;
Dexmedetomidine;
Respiratory aspiration of gastric contents
- MeSH:
Aged;
Anesthesia, Spinal;
Conscious Sedation;
Dexmedetomidine;
Femur;
Hemodynamics;
Humans;
Midazolam;
Respiratory Aspiration of Gastric Contents;
Respiratory Insufficiency
- From:Anesthesia and Pain Medicine
2019;14(2):236-240
- CountryRepublic of Korea
- Language:English
-
Abstract:
Recently, balanced sedation has commonly been used during procedural sedation. Dexmedetomidine is known for its relative safety to cause “conscious sedation” with little respiratory depression but has some limitations such as frequent awakening and hemodynamic instability during surgery. To facilitate sedation, a small dose of midazolam can be co-administered rather than escalating the dose of dexmedetomidine, especially in elderly patient. Despite the respiratory safety profile of dexmedetomidine, the overall safety of co-administration has not been clarified. We describe the first case of fatal pulmonary aspiration that developed in an elderly patient during balanced sedation with spinal anesthesia for elective femur fracture surgery.
