Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial

Abstract

SummaryBackground Delirium is a postoperative complication that occurs frequently in patients older than 65 years, and presages adverse outcomes. We investigated whether prophylactic low-dose dexmedetomidine, a highly selective α 2 adrenoceptor agonist, could safely decrease the incidence of delirium in elderly patients after non-cardiac surgery.

Delirium in the Cardiac Intensive Care Unit

“…These investigators found that only a small proportion of dexmedetomidine studies investigated its effect on delirium, reflecting a potentially lower quality of evidence influenced by risk of bias, imprecision, and significant publication bias. However, further trials favoring dexmedetomidine were published since this meta‐analysis62 and a recent meta‐analysis comparing dexmedetomidine to propofol in post‐cardiac surgery patients that included 8 randomized trials demonstrated that dexmedetomidine was associated with a lower risk of delirium (risk ratio, 0.4; 95% CI, 0.24–0.64; P =0.0002) as well as shorter length of intubation, but more bradycardia 68…”

The status of intensive care medicine research and a future agenda for very old patients in the ICU

“…A multicentre study on that strategy has just been completed and is awaiting final analyses [22]. Experiences from perioperative care in VOPs also suggest that preoperative prophylaxis with haloperiodol [23] and recently with dexmedetomidine [24] also may be effective.…”

Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery

“…Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery those that are not intubated, reduces the risk of delirium in the postoperative period (26).…”