Korean J Thorac Cardiovasc Surg.  2014 Jun;47(3):249-254.

Efficacy and Safety of Dexmedetomidine for Postoperative Delirium in Adult Cardiac Surgery on Cardiopulmonary Bypass

• Park JB
• Bang SH
• Chee HK
• Kim JS
• Lee SA
• Shin JK

Abstract

BACKGROUND
Delirium after cardiac surgery is associated with serious long-term negative outcomes and high costs. The aim of this study is to evaluate neurobehavioral, hemodynamic, and sedative characteristics of dexmedetomidine, compared with the current postoperative sedative protocol (remifentanil) in patients undergoing open heart surgery with cardiopulmonary bypass (CPB).
METHODS
One hundred and forty two eligible patients who underwent cardiac surgery on CPB between April 2012 and March 2013 were randomly divided into two groups. Patients received either dexmedetomidine (range, 0.2 to 0.8 microg/kg/hr; n=67) or remifentanil (range, 1,000 to 2,500 microg/hr, n=75). The primary end point was the prevalence of delirium estimated daily via the confusion assessment method for intensive care.
RESULTS
When the delirium incidence was compared with the dexmedetomidine group (6 of 67 patients, 8.96%) and the remifentanil group (17 of 75 patients, 22.67%) it was found to be significantly less in the dexmedetomidine group (p<0.05). There were no statistically significant differences between two groups in the extubation time, ICU stay, total hospital stay, and other postoperative complications including hemodynamic side effects.
CONCLUSION
This preliminary study suggests that dexmedetomidine as a postoperative sedative agent is associated with significantly lower rates of delirium after cardiac surgery.

Keyword

Postoperative care; Dexmedetomidine; Complication; Thoracic surgery

MeSH Terms

Adult*
Cardiopulmonary Bypass*
Delirium*
Dexmedetomidine*
Hemodynamics
Humans
Incidence
Critical Care
Length of Stay
Postoperative Care
Postoperative Complications
Prevalence
Thoracic Surgery*
Dexmedetomidine