{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T16:20:03Z","timestamp":1783441203357,"version":"3.54.6"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>High-activity postoperative delirium (POD) represents a prevalent neuropsychiatric complication during the perioperative period. Current clinical research predominantly focuses on preventive strategies, while effective pharmacological interventions remain limited, particularly for acute high-active subtypes. This case report demonstrates the successful use of dexmedetomidine nasal spray in managing acute high-active POD. The dexmedetomidine exerts its therapeutic effects through selective modulation of the locus coeruleus-noradrenergic pathway, providing physiological sedation resembling natural sleep architecture while preserving respiratory stability. It also exerts analgesic and anti-inflammatory effects. The nasal spray facilitated precise dosing with rapid symptom resolution and maintained hemodynamic stability. This novel approach offers a safe and effective way to manage acute high-active POD.<\/jats:p>","DOI":"10.3389\/fmed.2025.1600737","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T05:49:54Z","timestamp":1759297794000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Dexmedetomidine nasal spray to treat high-activity postoperative delirium: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Yujing","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"afad086","DOI":"10.1093\/ageing\/afad086","article-title":"Development and validation of an international preoperative risk assessment model for postoperative delirium","volume":"52","author":"Dodsworth","year":"2023","journal-title":"Age Ageing"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1001\/jama.2021.22647","article-title":"Effect of regional vs general Anesthesia on incidence of Postoperative Delirium in older patients undergoing hip fracture surgery: the RAGA randomized trial","volume":"327","author":"Li","year":"2022","journal-title":"JAMA"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1097\/EJA.0b013e328349b7f5","article-title":"Postoperative delirium. 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