Analgesic effect of dexmedetomidine in a patient with herpetic stomatitis after living-donor lung transplantation

Abstract

A 31-year-old woman suffering from bronchiolitis obliterans received bilateral living-donor lung transplantation to treat end-stage respiratory failure. After 5 days' mechanical ventilation, the patient was successfully extubated. During mechanical ventilation, the patient was sedated with a continuous intravenous infusion of propofol and dexmedetomidine (DEX). To assuage postoperative pain, morphine was infused, first intravenously, then epidurally. The administration of DEX was continued after extubation to prevent agitation. After the administration of epidural morphine was discontinued on day 10 in the intensive care unit (ICU), the patient complained of pain in the oral cavity. Greater pain was reported after the discontinuation of DEX, and symptoms of tachycardia and dyspnea appeared. A dermatologist diagnosed the oral symptoms as herpetic stomatitis, and a course of treatment with aciclovir was begun. A continuous infusion of DEX was again started on the same day, and was continued until ICU day 13. During the administration of DEX, the oral cavity pain was bearable. The patient was successfully discharged from the ICU on ICU day 13. We conclude that DEX could be used to provide analgesia for herpetic stomatitis after living-donor lung transplantation, at a dosage that achieves appropriate sedation.

Analgesic Effects of Dexmedetomidine in Vincristine-Evoked Painful Neuropathic Rats

“…It is also reported that dexmedetomidine showed an analgesic effect in an ischemic, acute postoperative, and intractable cancer pain of human and herpetic stomatitis after living-donor lung transplantation (5-7). Moreover, dexmedetomidine exhibits antinociceptive actions on postoperative, streptozotocin-induced, complete Freund's adjuvant (CFA)-induced, formalin-induced, carrageenan-induced inflammatory, acute nociceptive, and neuropathic pain in various animal models (8, 9).…”