Preventive Effect of Suvorexant for Postoperative Delirium after Coronary Artery Bypass Grafting

Abstract

Suvorexant might reduce incidence of POD in patients undergone CABG.

Suvorexant for the prevention of delirium

“…Finally, 7 studies (suvorexant treatment group, n = 402; control group, n = 487) were included in our meta-analysis. [ 16 – 21 , 24 ]…”

“…Three studies were designed as prospective RCTs, [ 17 , 20 , 24 ] while the other 4 were retrospective case-control studies. [ 16 , 18 , 19 , 21 ] Two trials were performed for patients in ICU, [ 19 , 20 ] 4 for non-ICU population [ 16 , 18 , 21 , 24 ] and 1 included both of the ICU and non-ICU patients. [ 17 ] The average daily dose was 15 or 20 mg.…”

“…Delirium was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) in 4 studies, [ 17 , 20 , 21 , 24 ] Confusion Assessment Method for Intensive Care Unit (CAM-ICU) in 2 studies [ 18 , 19 ] and Intensive Care Delirium Screening Checklist (ICDSC) in 1 study. [ 16 ] The total NOS scores varied from 8 to 9, indicating all eligible studies of high-quality (Table 2 ).…”

“…All 7 studies evaluated the prevention effects of suvorexant on the incidence of delirium [ 16 – 21 , 24 ] (Table 3 ). A fixed-effect model was used for the meta-analysis because there was no heterogeneity present among the studies ( I 2 = 15.9%, P = .311).…”

“…For example, Tamura et al found the incidence of delirium in patients undergoing elective coronary artery bypass grafting was significantly lower in the suvorexant treatment group than that in the control group (2.8% vs 21.2%; P = .008). [ 16 ] Hatta et al reported delirium developed less among acute care patients taking suvorexant than those without suvorexant administration (0% vs 17%; P = .025). [ 17 ] Kawada et al demonstrated the addition of suvorexant to ramelteon reduced the delirium risk in acute stroke patients (7.0% vs 31%, P < .001).…”