Severe hypotension following sublingual dexmedetomidine administration in an elderly patient

This case highlights the hemodynamic vulnerability of older adults, especially those with comorbidities and recent anticoagulation. While sublingual dexmedetomidine offers a noninvasive option for agitation management, its hypotensive potential may be clinically significant in this population. Our findings underscore the need for careful patient selection, dose optimization, and close monitoring when using dexmedetomidine in elderly patients, especially those with limited cardiovascular reserve. Further research is needed to guide safe dosing in geriatric and medically complex populations.