COMPARATIVE STUDY BETWEEN PROPOFOL AND DEXMEDETOMIDINE SEDATION IN REDUCING DELIRIUM AFTER CARDIAC SURGERY IN ELDERLY PATIENTS

Sharaf, Samia Ibrahim; Hefny, Sameh Salem; Anis, Sherif George; Elfar, Marwa Mamdouh; Rashed, Ahmed Abd El-kader

doi:10.21608/asmj.2020.125678

COMPARATIVE STUDY BETWEEN PROPOFOL AND DEXMEDETOMIDINE SEDATION IN REDUCING DELIRIUM AFTER CARDIAC SURGERY IN ELDERLY PATIENTS

Document Type : Original Article

Authors

¹ Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

² Intensive care specialist, National heart institute, Cairo. Egypt.

10.21608/asmj.2020.125678

Abstract

Background: Delirium is an acute mental disorder that involves changes in consciousness, attention, cognition, and perception. Postoperative delirium occurs frequently in patients after cardiac surgery and is associated with a prolonged hospital stay, higher costs, and increased morbidity and mortality. Aim of the work: To evaluate and compare propofol vs
dexmedetomidine sedation in reducing the incidence of postoperative delirium in elderly patients after cardiac surgery.
Patients and methods: The study was done on 150 patients to compare dexmedetomidine versus propofol in reducing delirium postcardiac surgery in elderly patients. They were divided into 2 equal groups; 75 patients received dexmedetomidine in a dose ranging from 0.2 μg/kg/hr up to max 0.7μg/kg/hr immediately post-operative, the other group; 75 Patients in the propofol group receiving propofol infusion in ICU from 25 to max 50 μg/kg/ min. until readiness for tracheal extubation. Assessment of delirium was performed with confusion assessment method for ICU .Primary outcome was the incidence of POD. Results: The result of this study showed that there was a statistically significant decrease of incidence of delirium in dexmedetomidine group (17.3%) in comparison to Propofol group (32%) (P < 0.05), there was a statistically significant delayed onset of delirium and there was a statistically significant decrease of mean
days of delirium in dexmedetomidine and propofol groups respectively. There was a statistically significant decrease in mean hours of mechanical ventilation in dexmedetomidine group in comparison to propofol group (P < 0.05). Also, our study showed that there was a statistically significant increase in ICU and hospital stay in patients with delirium in comparison to patients without delirium (P < 0.0001). Conclusion: The study revealed that dexmedetomidine reduced
the Incidence, delayed onset, and shortened duration of delirium in elderly patients after cardiac surgery, without difference in length of stay in ICU and hospital length of stay when compared with propofol.

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