title: Prophylaxis of dexamethasone protects patients from further post-operative delirium after cardiac surgery: A randomized trial.
abstract: BACKGROUND
  Coronary artery bypass graft is one of common cardiac surgeries which unfortunately accompany with some adverse events such as delirium. Proinflammatory processes play an important role in pathogenesis of post-operative delirium. Therefore, the effect of dexamethasone (DEX) on post-operative delirium after cardiac surgery was evaluated.
  
  
  METHODS
  This randomized clinical trial study was conducted with objective of evaluation of DEX effects on post-operative deliriums and complications after cardiac surgery. Ninety three eligible patients who undergone coronary arteries bypass graft was divided into two groups of DEX with 43 patients and placebo (PCB) with 50 patients. DEX group taken 8 mg DEX intra-venous before induction of anesthesia followed by 8 mg every 8 h for 3 day and other group received PCB in same way.
  
  
  RESULTS
  All patients assessed by Mini-mental status questionnaire and psychiatric interviewing with aim of diagnosing delirium. Extubation time of DEX group was significantly reduced. The first post-operative day deliriums, extubation time, hospital, and intensive-care unit length of stay significantly reduced in DEX group without increasing serious complications such as infectious disease. After administration of DEX only hyperglycemia as an adverse event was increased in DEX group. Other complications of renal, cardiac, cerebrovascular and respiratory system did not show any significant differences between groups.
  
  
  CONCLUSIONS
  Pre-operative administration of DEX might safely protect brain of the patients who undergone cardiac surgery against post-operative delirium.
authors.affiliation: Department of Nursing, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Davoud
authors.initials: D
authors.lastname: Mardani
authors.forename: Hamid
authors.initials: H
authors.lastname: Bigdelian
keywords: Cardiac surgery; clinical trial; delirium; dexamethasone
references.citation: Brain Res. 2009 Feb 13;1254:138-48
references.pmid: 19103180
references.citation: Curr Probl Surg. 2010 Mar;47(3):185-250
references.pmid: 20159189
references.citation: J Crit Care. 2009 Sep;24(3):458-63
references.pmid: 19327322
references.citation: J Psychosom Res. 1999 May;46(5):479-83
references.pmid: 10404482
references.citation: Ann Thorac Surg. 2010 Oct;90(4):1134-41
references.pmid: 20868803
references.citation: Ann Thorac Surg. 2006 Aug;82(2):597-607
references.pmid: 16863771
references.citation: Neuroscience. 2009 Jan 23;158(2):823-32
references.pmid: 19007863
references.citation: Best Pract Res Clin Anaesthesiol. 2004 Sep;18(3):425-38
references.pmid: 15212337
references.citation: Surgery. 2006 Aug;140(2):221-6
references.pmid: 16904973
references.citation: Intensive Care Med. 2007 Jun;33(6):941-50
references.pmid: 17410344
references.citation: Asian Cardiovasc Thorac Ann. 2007 Apr;15(2):167-77
references.pmid: 17387205
references.citation: J Psychiatr Res. 2001 May-Jun;35(3):127-45
references.pmid: 11461709
references.citation: Eur J Cardiothorac Surg. 2002 Oct;22(4):559-64
references.pmid: 12297172
references.citation: J Thorac Cardiovasc Surg. 2002 Jan;123(1):137-44
references.pmid: 11782767
references.citation: Curr Opin Crit Care. 2006 Oct;12(5):388-94
references.pmid: 16943714
references.citation: J Nerv Ment Dis. 1986 Feb;174(2):73-83
references.pmid: 3944597
references.citation: Exp Neurol. 2007 Oct;207(2):227-37
references.pmid: 17698063
references.citation: Br J Anaesth. 2002 Apr;88(4):496-501
references.pmid: 12066724
references.citation: J Surg Res. 2006 Dec;136(2):266-72
references.pmid: 17054992
references.citation: Eur J Cardiothorac Surg. 2005 Dec;28(6):889-95
references.pmid: 16271479
references.citation: Ann Thorac Surg. 2000 May;69(5):1420-4
references.pmid: 10881816
references.citation: Intensive Care Med. 2005 Jan;31(1):146-50
references.pmid: 15502933
references.citation: Prog Neuropsychopharmacol Biol Psychiatry. 1990;14(3):297-308
references.pmid: 2359841
references.citation: Ann Thorac Surg. 2008 Feb;85(2):554-60
references.pmid: 18222263
references.citation: Int J Geriatr Psychiatry. 1997 Jan;12(1):101-8
references.pmid: 9050431
references.citation: Chest. 2005 Nov;128(5):3664-70
references.pmid: 16304328
references.citation: J Psychosom Res. 2006 Feb;60(2):185-93
references.pmid: 16439272
references.citation: J Cardiothorac Vasc Anesth. 2011 Feb;25(1):156-65
references.pmid: 20537923
references.citation: Anesth Analg. 2011 May;112(5):1186-93
references.pmid: 21415433
references.citation: Cytokine. 2005 Feb 7;29(3):95-104
references.pmid: 15613277
references.citation: J Thorac Cardiovasc Surg. 2005 Jul;130(1):93-8
references.pmid: 15999046
references.citation: Ann Thorac Surg. 2009 Jul;88(1):106-10
references.pmid: 19559204
references.citation: Med Clin North Am. 2009 Sep;93(5):979-94
references.pmid: 19665615