The Effect of Intraoperative Dexmedetomidine on Postoperative Delirium Sedation Agitation Score in cardiac surgery

Abstract

Background: Postoperative delirium is a significant problem that deteriorates the cognitive state of patients after cardiac surgery, which can be a short- or long-term complication. Objectives: This study was conducted to evaluate the efficacy of dexmedetomidine, commenced simultaneously with anesthesia induction and continued throughout the surgical operation, on postoperative delirium after cardiac surgery with cardiopulmonary bypass. Methods: This randomized, double-blind, case-control trial was conducted on sixty-one patients undergoing cardiac surgery. The patients were randomly divided into dexmedetomidine (case) and normal saline (control) groups. The primary outcome was the incidence of delirium, as screened by the Confusion Assessment Method for the ICU (CAM-ICU). Results: There was no distinction in CAM-ICU outcomes between the two groups at 6 and 24 hours postoperatively. However, the difference in non-positive CAM-ICU results was statistically significant at 24 hours for +1 and -1 Richmond Agitation-Sedation Scale scores. Conclusions: Starting dexmedetomidine before cardiopulmonary bypass did not significantly affect the delirium rate based on CAM-ICU assessments. Further research examining larger groups is necessary to clarify the efficacy of perioperative dexmedetomidine on postoperative delirium.