A Case Series on the Utility of Dexmedetomidine for the Immediate Treatment of Postoperative Muscle Spasm

Abstract

Postoperative muscle spasm is a common complaint in the post-anesthesia care unit. Management of postoperative muscle spasm remains a major challenge as first-line anti-spasmodic agents are not without risk. Due to the adverse effects of sedation and risk for respiratory depression and pulmonary aspiration, conventional anti-spasmodic agents may not be an ideal choice for patients who are recovering from anesthesia. In this case series, we present three patients who underwent nonemergent surgeries with subsequent postoperative cervical muscle spasm that went unresolved with conventional PACU pain medications. Below, we demonstrate the potential utility of dexmedetomidine for management of postoperative muscle spasm. This is most notable when oral anti-spasmodic formulations are contraindicated in sedated patients and intravenous skeletal muscle relaxants are inaccessible in the PACU. After receiving incremental boluses of dexmedetomidine, the patients demonstrated immediate improvement in their cervical range of motion and their cervical muscle spasms were markedly reduced. Dexmedetomidine’s unique qualities, such as its quick onset, intravenous route of administration, and minimal effect on respiratory physiology, make it an ideal choice for management of postoperative muscle spasm.