Perioperative Benefits of Dexmedetomidine as an Antiarrhythmic Agent in Noncardiac Surgical Patients:

Dexmedetomidine (DEX), a selective α2-adrenergic receptor agonist, has gained recognition for its sedative, anxiolytic, and sympatholytic properties, making it a valuable perioperative agent. This report describes the anaesthetic management of an elderly 75-year-old male patient with septic shock, multi-organ dysfunction, delirium and significant ventricular arrhythmias who presented in 2025 to a tertiary care teaching hospital in Oman and was scheduled for an emergency below-knee amputation. DEX was utilised for intraoperative sedation and its antiarrhythmic effects. Traditional sedatives often exacerbate delirium or pose cardiorespiratory risks; however, DEX provides effective sedation while preserving respiratory function and promoting haemodynamic stability. Notably, its use contributed to a marked suppression of ventricular ectopy and arrhythmias during surgery, likely through attenuation of the catecholamine surge and reduced myocardial excitability. This case highlights the dual benefit of DEX in managing complex surgical patients with neuropsychiatric and cardiac comorbidities, underscoring its potential as a preferred agent in similar clinical scenarios. Further studies are warranted to explore its broader application in arrhythmia-prone, delirious patients undergoing noncardiac surgeries.