title: Morphine is a reasonable alternative to haloperidol in the treatment of postoperative hyperactive-type delirium after cardiac surgery.
abstract: OBJECTIVE
  Patients who undergo cardiac surgery have an increased risk of delirium. Currently, there are few choices of treatment for postoperative hyperactive delirium in cardiac surgical patients. The aim of this study was to assess the effect of morphine compared with a haloperidol-based regimen in hyperactive-type delirium in patients after cardiac surgery.
  
  
  METHODS
  A prospective, randomized clinical study.
  
  
  METHODS
  A single community hospital.
  
  
  METHODS
  Fifty-three consecutive, adult, delirious patients.
  
  
  METHODS
  Patients were randomized into 2 groups; in group 1, patients received 5mg of haloperidol intramuscularly and in group 2, patients received 5mg of morphine sulfate intramuscularly to control delirium symptoms.
  
  
  RESULTS
  During the second and third hour of the morphine treatment, statistically low Richmond Agitation and Sedation Scale scores were found and the target Richmond Agitation and Sedation Scale scores percentages were statistically higher than those of the haloperidol group (p = 0.042 and p = 0.028, respectively). The number of patients requiring additive sedatives was significantly more in the haloperidol group when compared with the morphine group (p = 0.011).
  
  
  CONCLUSIONS
  During the treatment of patients, it was determined that the patients who were receiving morphine treatment responded more quickly compared with the patients receiving haloperidol treatment. Morphine was found to be a reasonable alternative to haloperidol in the treatment of postoperative hyperactive delirious patients after cardiac surgery.
authors.affiliation: Department of Anesthesiology and Intensive Care, Medicana Hospitals Bahcelievler, Istanbul, Turkey. Electronic address: drnazan@hotmail.com.
authors.forename: Nazan
authors.initials: N
authors.lastname: Atalan
authors.forename: Meltem
authors.initials: M
authors.lastname: Efe Sevim
authors.forename: Serdar
authors.initials: S
authors.lastname: Akgün
authors.forename: Osman
authors.initials: O
authors.lastname: Fazlıoğulları
authors.forename: Cem
authors.initials: C
authors.lastname: Başaran
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003693:Delirium / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006220:Haloperidol / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology
chemical_list: D014150:Antipsychotic Agents; D009020:Morphine; D006220:Haloperidol
keywords: cardiac surgery; delirium; haloperidol; intensive care unit (ICU); morphine; treatment