A randomised controlled trial of dexmedetomidine for delirium in adults undergoing heart valve surgery

Anaesthesia. 2023 May;78(5):571-576. doi: 10.1111/anae.15983. Epub 2023 Feb 16.

Abstract

Dexmedetomidine might reduce delirium after cardiac surgery. We allocated 326 participants to an infusion of dexmedetomidine at a rate of 0.6 μg kg-1 for 10 min and then at 0.4 μg.kg-1 .h-1 until the end of surgery; 326 control participants received comparable volumes of saline. We detected delirium in 98/652 (15%) participants during the first seven postoperative days: 47/326 after dexmedetomidine vs. 51/326 after placebo, p = 0.62, adjusted relative risk (95%CI) 0.86 (0.56-1.33), p = 0.51. Postoperative renal impairment (Kidney Disease Improving Global Outcomes stages 1, 2 and 3) was detected in 46, 9 and 2 participants after dexmedetomidine and 25, 7 and 4 control participants, p = 0.040. Intra-operative dexmedetomidine infusion did not reduce the incidence of delirium after cardiac valve surgery but might impair renal function.

Keywords: acute kidney injury; anaesthesia; cardiac surgery; cardiopulmonary bypass; dexmedetomidine; postoperative delirium.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cardiac Surgical Procedures* / adverse effects
  • Delirium* / epidemiology
  • Delirium* / prevention & control
  • Dexmedetomidine* / therapeutic use
  • Double-Blind Method
  • Heart Valves / surgery
  • Humans
  • Incidence

Substances

  • Dexmedetomidine