Comparative Characteristics of Effectiveness and Safety of Adjuvant Sedation of Patients With Alcoholic Delirium

Abstract

Chronic alcoholism is one of the factors of early mortality in the world. The most formidable complication of this addiction is the state of alcohol withdrawal with delirium. It is based on a long-term imbalance of the GABA and glutamatergic systems in the brain. Today, the search for an optimal sedation regimen that would be effective on the one hand, and, on the other hand, would have a sufficient safety profile, remains relevant.
 Three sedation regimens with the addition of ketamine, sodium oxybutyrate and dexmedetomidine were investigated. All were compared with the traditional sedation (control) regimen and with each other. The control points of the study were the following parameters: the duration of the episode of delirium, hemodynamics, plasma cortisol and serotonin, laboratory parameters of the state of the kidneys and liver.
 As a result of the study, we found that all of the proposed schemes had a shorter duration of delirium compared to the control. The shortest episodes of delirium were observed in the dexmedetomidine group. None of the proposed groups could adequately normalize hemodynamic parameters. We believe that the reason for this is both the peculiarities of the mechanism of action of the drugs we have chosen, and electrolyte imbalance, in particular, hypomagnesemia. The safety of our proposed sedation regimens requires further comprehensive research