The Efficacy of Dexmedetomidine alone or with Melatonin on Delirium after Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial.

Autor:	Javaherforooshzadeh F; Department of Anesthesia, Pain Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran., Babazadeh Dezfoli A; Pain Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran., Saki Malehi A; Department of Biostatistics and Epidemiology, Pain Research Centre, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran., Gholizadeh B; Department of Cardiac Surgery, Pain Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Jazyk:	angličtina
Zdroj:	Anesthesiology and pain medicine [Anesth Pain Med] 2023 Aug 22; Vol. 13 (4), pp. e138317. Date of Electronic Publication: 2023 Aug 22 (Print Publication: 2023).
DOI:	10.5812/aapm-138317
Abstrakt:	Background: One of the most common cognitive disorders after major surgery is delirium which can increase morbidity and mortality. This study compared the effect of dexmedetomidine with or without melatonin to reduce delirium following coronary artery bypass graft (CABG) surgery. Methods: This trial was a double-blind, randomized, controlled clinical trial. Eighty patients in two different groups with the administration of dexmedetomidine alone or with melatonin undergoing CABG surgery in Golestan Hospital, Ahvaz, 2022 - 2023, were randomly allocated. This study evaluated the occurrence, onset, and length of delirium, haloperidol, the time required for weaning, and the duration of stays in the intensive care unit (ICU) and hospital. Results: The occurrence of delirium was lower in the melatonin/dexmedetomidine group (15%) than in the dexmedetomidine group (30 %) (P = 0.09). Additionally, the melatonin/dexmedetomidine group had a significantly lower duration of delirium than the dexmedetomidine group (1.95 (0, 20) and 8.46 (0, 40) P = 0.04). However, no significant difference was observed in the onset of delirium between the two groups (P = 0.25). The length of hospital stays in the melatonin/dexmedetomidine group was significantly shorter than in the dexmedetomidine group (7.53 (7, 10) and 8.60 (7, 15), P = 0.03). However, the two groups demonstrated no significant difference between extubation (P = 0.38) and length of ICU stay (P = 0.19). Conclusions: The administration of melatonin and dexmedetomidine reduced the incidence of post-cardiac surgery delirium, shortened its duration, and decreased the impact of many risk factors observed in those not receiving the added melatonin. Competing Interests: The authors have no competing interests. (Copyright © 2023, Javaherforooshzadeh et al.)
Databáze:	MEDLINE
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