title: Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery.
abstract: BACKGROUND
  Delirium is a neurobehavioral syndrome caused by the transient disruption of normal neuronal activity secondary to systemic disturbances.
  
  
  OBJECTIVE
  The authors investigated the effects of postoperative sedation on the development of delirium in patients undergoing cardiac-valve procedures.
  
  
  METHODS
  Patients underwent elective cardiac surgery with a standardized intraoperative anesthesia protocol, followed by random assignment to one of three postoperative sedation protocols: dexmedetomidine, propofol, or midazolam.
  
  
  RESULTS
  The incidence of delirium for patients receiving dexmedetomidine was 3%, for those receiving propofol was 50%, and for patients receiving midazolam, 50%. Patients who developed postoperative delirium experienced significantly longer intensive-care stays and longer total hospitalization.
  
  
  CONCLUSIONS
  The findings of this open-label, randomized clinical investigation suggest that postoperative sedation with dexmedetomidine was associated with significantly lower rates of postoperative delirium and lower care costs.
authors: Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Suite 2317, Stanford, CA 94305-5546, USA. jrm@stanford.edu
authors: José R
authors: JR
authors: Maldonado
authors: Ashley
authors: A
authors: Wysong
authors: Pieter J A
authors: PJ
authors: van der Starre
authors: Thaddeus
authors: T
authors: Block
authors: Craig
authors: C
authors: Miller
authors: Bruce A
authors: BA
authors: Reitz
mesh_terms: D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass; D003693:Delirium / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D020927:Dexmedetomidine / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007362:Intensive Care Units; D008297:Male; D008874:Midazolam / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy*; D015742:Propofol / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D008874:Midazolam; D015742:Propofol