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Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery
José R Maldonado1, Ashley Wysong, Pieter J A van der Starre
1Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Suite 2317, Stanford, CA 94305-5546, USA. jrm@stanford.edu
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.
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