Critical Care and Shock

Prolonged dexmedetomidine infusion to facilitate drug detoxification and withdrawal in patients with multiple drugs addiction

Abstract

Many patients are admitted to intensive care unit for acute intoxication, serious complication of overdose or withdrawal symptoms of illicit drugs. Acute withdrawal of drug with addiction potential is associated with sympathetic over-activity leading to marked psychomimetic disturbances. Acute intoxication or withdrawal of such drugs are often associated with life threatening complication which requires ICU admission and necessitates prolonged sedative-analgesic medications, whereas weaning from which is often complicated by withdrawal and other psychomimetic symptoms. Dexmedetomidine, an α2 agonist has been used successfully to facilitate withdrawal and detoxification of various drugs and also to control delirium in ICU patients. Herein we reported two cases of chronic substance abuse patients admitted with acute overdose complication leading to prolonged ICU course requiring sedative-analgesic, and later the drug withdrawal related symptoms further complicated the weaning process. Dexmedetomidine infusion was successfully used as sedative-analgesic to control the withdrawal related psychomimetic symptoms and to facilitate smooth detoxification and weaning from opioid and other sedatives