Polyuria during endonasal endoscopic surgery: An atypical effect of intraoperative dexmedetomidine administration

Dexmedetomidine-induced polyuria in the intensive care unit: a case report

“…In 6 reports, polyuria developed 2 hours after dexmedetomidine administration and dissolved after its discontinuation. [10][11][12][13][14] This process is similar to our patient. In these cases, the dexmedetomidine dose was in the range of 0.3 to 2 μg/kg per hour.…”

Perioperative Diabetes Insipidus Caused by Anesthetic Medications: A Review of the Literature

“…In some cases, anesthetic-induced DI/ polyuria was suspected, and the presumed offending agent was removed resulting in prompt resolution of symptoms. 2,[7][8][9][10]15,25,26 For instance, Haldar et al 7 reported, "that within 1 hour there was a spontaneous and dramatic decrease in urine production." Pratt et al 10 reported "as dexmedetomidine was discontinued, the patients urine output returned to [the patient's baseline of] 45 from 275 mL/h."…”

“…In some cases, anesthetic-induced DI/polyuria was suspected, and the presumed offending agent was removed resulting in prompt resolution of symptoms. 2,7–10,15,25,26 For instance, Haldar et al 7 reported, “that within 1 hour there was a spontaneous and dramatic decrease in urine production.” Pratt et al 10 reported “as dexmedetomidine was discontinued, the patients urine output returned to [the patient’s baseline of] 45 from 275 mL/h.” Frequency of DDAVP and vasopressin administration are noted in Tables 1 and 2. The majority of patients were treated with intravenous fluid replacement and monitoring of electrolytes, plasma, and urine osmolality.…”

“…28–31 Though this polyuric response has not been demonstrated in human studies, a growing number of case reports has suggested a link between dexmedetomidine use and DI. 5–13,25,26 Case reports have implicated both continuous infusions for several hours as well as a single loading dose of 1 μg/kg. 12…”

“…Of the 3 cases categorized as neuro/otolaryngology (ENT) cases, only 1 involved an endonasal skull base approach that was proximal to the structures of the hypothalamic-pituitary axis. 7 The authors noted the polyuria began before any tumor resection. There are no other well-documented associations between procedure type and DI, and none were identified in our study.…”