Postoperative delirium after coronary artery bypass graft surgery: Dexmedetomidine infusion alone or with the addition of oral melatonin
ABSTRACTIntroduction: Postoperative delirium is a common complication of cardiac surgery. This study aimed to assess the effect of supplementing dexmedetomidine infusion with oral melatonin in prevention of postoperative delirium after coronary artery bypass graft surgery.Methods: 110 patients of bo...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-01-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2021.1885956 |
| _version_ | 1797683828581466112 |
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| author | Ramy Mahrose Heba ElSerwi Alfred Maurice Mayar Elsersi |
| author_facet | Ramy Mahrose Heba ElSerwi Alfred Maurice Mayar Elsersi |
| author_sort | Ramy Mahrose |
| collection | DOAJ |
| description | ABSTRACTIntroduction: Postoperative delirium is a common complication of cardiac surgery. This study aimed to assess the effect of supplementing dexmedetomidine infusion with oral melatonin in prevention of postoperative delirium after coronary artery bypass graft surgery.Methods: 110 patients of both sexes above 60 years of age were included. Anesthetic management was standardized. Patients were randomly allocated into one of the two study groups, dexmedetomidine/melatonin (DM) group or dexmedetomidine (D) group. Patients in the DM group received oral Melatonin tablet 5 mg the night before surgery and same dose was repeated every 24 hours for 3 postoperative days. After completion of surgery and upon ICU arrival, patients in both groups received a bolus of 0.4 µg/kg dexmedetomidine followed by 0.2–0.7 µg/kg/h infusion, for 24 maximum hours. Delirium was assessed for 5 days postoperatively at 12 hr intervals using confusion assessment method (CAM) for ICU and after discharge from ICU to surgical ward using CAM. Delirious patients were treated with IV haloperidol.Results: No significant differences between studied groups regarding baseline, preoperative, intraoperative and postoperative characteristics. Incidence of delirium was significantly lower, onset significantly more delayed, and duration was significantly shorter in group-DM as compared to group-D. No significant differences between all cases, cases who had delirium, and cases who did not have delirium in the two groups as regards extubation time, ICU stay, and hospital stay.Conclusion: supplementing dexmedetomidine with melatonin decreases incidence, delays onset, and shortens duration of postoperative delirium in patients above 60 years of age undergoing CABG surgery. |
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| format | Article |
| id | doaj.art-b8b2cbeec4c24bc3b049510682df712e |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-03-12T00:20:30Z |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-b8b2cbeec4c24bc3b049510682df712e2023-09-15T13:38:33ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492021-01-01371626810.1080/11101849.2021.1885956Postoperative delirium after coronary artery bypass graft surgery: Dexmedetomidine infusion alone or with the addition of oral melatoninRamy Mahrose0Heba ElSerwi1Alfred Maurice2Mayar Elsersi3Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine Ain Shams University, Cairo, EgyptDepartment of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine Ain Shams University, Cairo, EgyptDepartment of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine Ain Shams University, Cairo, EgyptDepartment of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine Ain Shams University, Cairo, EgyptABSTRACTIntroduction: Postoperative delirium is a common complication of cardiac surgery. This study aimed to assess the effect of supplementing dexmedetomidine infusion with oral melatonin in prevention of postoperative delirium after coronary artery bypass graft surgery.Methods: 110 patients of both sexes above 60 years of age were included. Anesthetic management was standardized. Patients were randomly allocated into one of the two study groups, dexmedetomidine/melatonin (DM) group or dexmedetomidine (D) group. Patients in the DM group received oral Melatonin tablet 5 mg the night before surgery and same dose was repeated every 24 hours for 3 postoperative days. After completion of surgery and upon ICU arrival, patients in both groups received a bolus of 0.4 µg/kg dexmedetomidine followed by 0.2–0.7 µg/kg/h infusion, for 24 maximum hours. Delirium was assessed for 5 days postoperatively at 12 hr intervals using confusion assessment method (CAM) for ICU and after discharge from ICU to surgical ward using CAM. Delirious patients were treated with IV haloperidol.Results: No significant differences between studied groups regarding baseline, preoperative, intraoperative and postoperative characteristics. Incidence of delirium was significantly lower, onset significantly more delayed, and duration was significantly shorter in group-DM as compared to group-D. No significant differences between all cases, cases who had delirium, and cases who did not have delirium in the two groups as regards extubation time, ICU stay, and hospital stay.Conclusion: supplementing dexmedetomidine with melatonin decreases incidence, delays onset, and shortens duration of postoperative delirium in patients above 60 years of age undergoing CABG surgery.https://www.tandfonline.com/doi/10.1080/11101849.2021.1885956Postoperative deliriummelatonindexmedetomidineCABG |
| spellingShingle | Ramy Mahrose Heba ElSerwi Alfred Maurice Mayar Elsersi Postoperative delirium after coronary artery bypass graft surgery: Dexmedetomidine infusion alone or with the addition of oral melatonin Egyptian Journal of Anaesthesia Postoperative delirium melatonin dexmedetomidine CABG |
| title | Postoperative delirium after coronary artery bypass graft surgery: Dexmedetomidine infusion alone or with the addition of oral melatonin |
| title_full | Postoperative delirium after coronary artery bypass graft surgery: Dexmedetomidine infusion alone or with the addition of oral melatonin |
| title_fullStr | Postoperative delirium after coronary artery bypass graft surgery: Dexmedetomidine infusion alone or with the addition of oral melatonin |
| title_full_unstemmed | Postoperative delirium after coronary artery bypass graft surgery: Dexmedetomidine infusion alone or with the addition of oral melatonin |
| title_short | Postoperative delirium after coronary artery bypass graft surgery: Dexmedetomidine infusion alone or with the addition of oral melatonin |
| title_sort | postoperative delirium after coronary artery bypass graft surgery dexmedetomidine infusion alone or with the addition of oral melatonin |
| topic | Postoperative delirium melatonin dexmedetomidine CABG |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2021.1885956 |
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