Dexmedetomidine's Relationship to Delirium in Patients Undergoing Cardiac Surgery: A Systematic Review

This systematic review aims to determine the relationship between postoperative delirium and the use of dexmedetomidine in comparison with commonly used sedatives/analgesics in the postoperative cardiac surgery patient. A systematic literature search of PubMed plus, CINAHL, Scopus, and Ovid, and limited to the English language in the last 10 years, was performed. Randomized controlled trials, observational and retrospective studies, and meta-analyses with at least 1 delirium assessment tool were included. The search found 196 potential articles; however, only 12 met the criteria outlined. The systematic review revealed a decrease in postoperative delirium for patients receiving dexmedetomidine in all studies. Seven studies demonstrated statistically significant reductions in postoperative delirium with dexmedetomidine compared with other sedatives/analgesics. One study also revealed reduction of delirium with dexmedetomidine as compared with normal saline. Two studies showed a delayed time to delirium onset in patients receiving dexmedetomidine versus propofol or morphine. The 2 meta-analyses found that all included studies had a statistically significant reduction in postoperative delirium when using dexmedetomidine. Postoperative use of dexmedetomidine in cardiac surgery patients may reduce the incidence of postoperative delirium.