Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery

Psychosomatics. 2009 May-Jun;50(3):206-17. doi: 10.1176/appi.psy.50.3.206.

Abstract

Background: Delirium is a neurobehavioral syndrome caused by the transient disruption of normal neuronal activity secondary to systemic disturbances.

Objective: The authors investigated the effects of postoperative sedation on the development of delirium in patients undergoing cardiac-valve procedures.

Methods: Patients underwent elective cardiac surgery with a standardized intraoperative anesthesia protocol, followed by random assignment to one of three postoperative sedation protocols: dexmedetomidine, propofol, or midazolam.

Results: The incidence of delirium for patients receiving dexmedetomidine was 3%, for those receiving propofol was 50%, and for patients receiving midazolam, 50%. Patients who developed postoperative delirium experienced significantly longer intensive-care stays and longer total hospitalization.

Conclusion: The findings of this open-label, randomized clinical investigation suggest that postoperative sedation with dexmedetomidine was associated with significantly lower rates of postoperative delirium and lower care costs.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Cardiopulmonary Bypass*
  • Delirium / chemically induced
  • Delirium / diagnosis
  • Delirium / drug therapy*
  • Dexmedetomidine / adverse effects
  • Dexmedetomidine / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis Implantation
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Hypnotics and Sedatives / therapeutic use*
  • Intensive Care Units
  • Male
  • Midazolam / adverse effects
  • Midazolam / therapeutic use
  • Middle Aged
  • Neuropsychological Tests
  • Postoperative Complications / diagnosis
  • Postoperative Complications / drug therapy*
  • Propofol / adverse effects
  • Propofol / therapeutic use

Substances

  • Hypnotics and Sedatives
  • Dexmedetomidine
  • Midazolam
  • Propofol