Postoperative delirium Delirium Dexmedetomidine Postoperative delirium Nocturnal dexmedetomidine
Conditions
Interventions
All management is the same to the nocturnal dexmedetomidine group, except the change from nocturnal dexmedetomidine to equivalent milliliters per hour of the placebo is administered to the patients (i
Active Comparator No treatment,Experimental Drug
0.9% NaCl,Dexmedetomidine
Sponsors
Faculty of Medicine Siriraj Hospital, Mahidol University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age 18 years or older undergoing non-cardiac surgery 2. Admitted to SICU immediately after surgery (before 6 PM on the day of surgery) 3. A predictive score of postoperative delirium of 115 or more 4. Expected to stay in SICU for more than 24 hours
Exclusion criteria
Exclusion criteria: 1. Unable to communicate in Thai 2. Preoperative history of schizophrenia, epilepsy, Parkinsonism, myasthenia gravis 3. Inability to communicate in the preoperative period (coma, profound dementia, or language barrier) 4. Admitted with a primary neurologic condition or injury 5. Known preoperative LVEF less than 30% 6. Sick sinus syndrome, severe sinus bradycardia (<50 beats per min [bpm]), or second-degree or greater atrioventricular block without pacemaker 7. Child-Pugh class C 8. Serious renal dysfunction (undergoing dialysis before surgery) 9. Known allergies or anaphylaxis of dexmedetomidine, propofol, midazolam, haloperidol 10. Expected death within 48 hours after surgery 11. Inability to obtain informed consent 12. Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Postoperative delirium 7 AM and 7 PM from postoperative day 1 to ICU discharge/ 7 days/ death Thai CAM-ICU | — |
Secondary
| Measure | Time frame |
|---|---|
| Bradycardia continuously throughout ICU admission ECG,Hypotension every hour NIBP or invasive arterial blood pressure,Episodes of nosocomial infection Review at ICU discharge Chart review,Duration of mechanical ventilation Review at ICU discharge Chart review,ICU length of stay Review at ICU discharge Chart review,Hospital length of stay Review at hospital discharge Chart review,In-hospital mortality Review at hospital discharge Chart review,amount of sedative and analgesic drugs Review at ICU discharge Chart review | — |
Countries
Thailand
Contacts
Public ContactOnuma Chaiwat
Mahidol University
Outcome results
None listed