What is the Delirium Bibliography? The searchable Delirium Bibliography page is one of our most popular features, allowing you to quickly gain access to the literature on delirium and acute care of older persons. It is primarily intended for clinicians and researchers interested in exploring these topics. The NIDUS team keeps it updated for you on a monthly basis!
How to Search for Articles: Search by author, title, year, and/or keywords. Each article is indexed by keywords taken from MEDLINE and other relevant databases. Click on the title of the article to read the abstract, journal, etc.
Reference Information
- Title
- Intravenous infusion of dexmedetomidine during the surgery to prevent postoperative delirium and postoperative cognitive dysfunction undergoing non-cardiac surgery: a meta-analysis of randomized controlled trials
- Authors
- Wang, D. Liu, Z. Zhang, W. Zu, G. Tao, H. Bi, C.
- Year
- 2024
- Journal
- Eur J Med Res
- Abstract
BACKGROUND: Dexmedetomidine plays a pivotal role in mitigating postoperative delirium and cognitive dysfunction while enhancing the overall quality of life among surgical patients. Nevertheless, the influence of dexmedetomidine on such complications in various anaesthesia techniques remains inadequately explored. As such, in the present study, a meta-analysis was conducted to comprehensively evaluate its effects on postoperative delirium and cognitive dysfunction. METHODS: A number of databases were searched for randomised controlled trials comparing intravenous dexmedetomidine to other interventions in preventing postoperative delirium and cognitive dysfunction in non-cardiac and non-neurosurgical patients. These databases included PubMed, Embase, and Cochrane Library. Statistical analysis and graphing were performed using Review Manager, STATA, the second version of the Cochrane risk-of-bias tool for randomised controlled trials, and GRADE profiler. MAIN RESULTS: This meta-analysis comprised a total of 24 randomised controlled trials, including 20 trials assessing postoperative delirium and 6 trials assessing postoperative cognitive dysfunction. Across these 24 studies, a statistically significant positive association was observed between intravenous administration of dexmedetomidine and a reduced incidence of postoperative delirium (RR: 0.55; 95% CI 0.47 to 0.64, p < 0.00001, I(2) = 2%) and postoperative cognitive dysfunction (RR: 0.60; 95% CI 0.38 to 0.96, p = 0.03, I(2) = 60%). Subgroup analysis did not reveal a significant difference in the incidence of postoperative delirium between the general anaesthesia and non-general anaesthesia groups, but a significant difference was observed in the incidence of postoperative cognitive dysfunction. Nonetheless, when the data were pooled, it was evident that the utilisation of dexmedetomidine was associated with an increased incidence of hypotension (RR: 1.42; 95% CI 1.08 to 1.86, p = 0.01, I(2) = 0%) and bradycardia (RR: 1.66; 95% CI 1.23 to 2.26, p = 0.001, I(2) = 0%) compared with other interventions. However, there was no significantly higher occurrence of hypertension in the DEX groups (RR = 1.35, 95% CI 0.81-2.24, p = 0.25, I(2) = 0%). CONCLUSION: Compared with other interventions, intravenous dexmedetomidine infusion during non-cardiac and non-neurosurgical procedures may significantly reduce the risk of postoperative delirium and cognitive dysfunction. The results of subgroup analysis reveal a consistent preventive effect on postoperative delirium in both general and non-general anaesthesia groups. Meanwhile, continuous infusion during general anaesthesia was more effective in reducing the risk of cognitive dysfunction. Despite such findings, hypotension and bradycardia were more frequent in patients who received dexmedetomidine during surgery.
- PMID
PMID: 38637853
PMCID: PMC11025279
- Keywords
Humans
Bradycardia/epidemiology
*Dexmedetomidine/therapeutic use
*Emergence Delirium/epidemiology/prevention & control
*Hypotension/epidemiology
Infusions, Intravenous
*Postoperative Cognitive Complications/prevention & control
Postoperative Complications/prevention & control/epidemiology
Quality of Life
Randomized Controlled Trials as Topic
Dexmedetomidine
Non-cardiac surgery and non-neurosurgery
Postoperative cognitive dysfunction
Postoperative delirium
- Page(s)
- Volume
- Issue
Title | Authors | Journal | Year | Keywords |
---|---|---|---|---|
Have you SCAND MMe Please? A framework to prevent harm during acute hospitalisation of older persons: A retrospective audit. | Redley, B. Baker, T. | Journal of Clinical Nursing | 2019 |
acute disease |
Low-Dose Ketamine Infusion to Decrease Postoperative Delirium for Spinal Fusion Patients. | Plyler, S. S. Muckler, V. C. Titch, J. F. Gupta, D. K. Rice, A. N. | J Perianesth Nurs | 2019 |
3d-cam |
Nurses' experiences of caring for older patients afflicted by delirium in a neurological department. | Kristiansen, S. Konradsen, H. Beck, M. | Journal of Clinical Nursing | 2019 |
adult |
Association of Delirium Response and Safety of Pharmacological Interventions for the Management and Prevention of Delirium: A Network Meta-analysis. | Wu, Y. C. Tseng, P. T. Tu, Y. K. Hsu, C. Y. Liang, C. S. Yeh, T. C. Chen, T. Y. Chu, C. S. Matsuoka, Y. J. Stubbs, B. Carvalho, A. F. Wada, S. Lin, P. Y. Chen, Y. W. Su, K. P. | JAMA Psychiatry | 2019 | |
Effect of electroencephalography-guided anesthetic administration on postoperative delirium among older adults undergoing major surgery the engages randomized clinical trial. | Wildes, T. S. Mickle, A. M. Abdallah, A. B. Maybrier, H. R. Oberhaus, J. Budelier, T. P. Kronzer, A. McKinnon, S. L. Park, D. Torres, B. A. Graetz, T. J. Emmert, D. A. Palanca, B. J. Goswami, S. Jordan, K. Lin, N. Fritz, B. A. Stevens, T. W. Jacobsohn, E. | JAMA | 2019 |
NCT02241655 |
Perioperative Epidural Use and Risk of Delirium in Surgical Patients: A Secondary Analysis of the PODCAST Trial. | Vlisides, P. E. Thompson, A. Kunkler, B. S. Maybrier, H. R. Avidan, M. S. Mashour, G. A. | Anesth Analg | 2019 | |
Effect of Intravenous Acetaminophen vs Placebo Combined with Propofol or Dexmedetomidine on Postoperative Delirium among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial. | Subramaniam, B. Shankar, P. Shaefi, S. Mueller, A. O'Gara, B. Banner-Goodspeed, V. Gallagher, J. Gasangwa, D. Patxot, M. Packiasabapathy, S. Mathur, P. Eikermann, M. Talmor, D. Marcantonio, E. R. | JAMA | 2019 |
NCT02546765 |
The use of a screening scale improves the recognition of delirium in older patients after cardiac surgery - a retrospective observational study. | Smulter, N. Claesson Lingehall, H. Gustafson, Y. Olofsson, B. Engstrom, K. G. | J Clin Nurs | 2019 |
Assessments scales |
Incidence and predictors of postoperative delirium in the older acute care surgery population: a prospective study. | Saravana-Bawan, B. Warkentin, L. M. Rucker, D. Carr, F. Churchill, T. A. Khadaroo, R. G. | Canadian Journal of Surgery | 2019 |
aged |
Association of Duration of Surgery With Postoperative Delirium Among Patients Receiving Hip Fracture Repair. | Ravi, B. Pincus, D. Choi, S. Jenkinson, R. Wasserstein, D. N. Redelmeier, D. A. | JAMA Netw Open | 2019 | |
Depression Predicts Delirium After Coronary Artery Bypass Graft Surgery Independent of Cognitive Impairment and Cerebrovascular Disease: An Analysis of the Neuropsychiatric Outcomes After Heart Surgery Study. | Oldham, M. A. Hawkins, K. A. Lin, I. H. Deng, Y. Hao, Q. Scoutt, L. M. Yuh, D. D. Lee, H. B. | American Journal of Geriatric Psychiatry | 2019 |
aged |
Accuracy of the Delirium Observational Screening Scale (DOS) as a screening tool for delirium in patients with advanced cancer. | Neefjes, E. C. W. van der Vorst, Mjdl Boddaert, M. S. A. Verdegaal, Batt Beeker, A. Teunissen, S. C. C. Beekman, A. T. F. Zuurmond, W. W. A. Berkhof, J. Verheul, H. M. W. | BMC Cancer | 2019 |
Delirium |
The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study. | Nagae, M. Egi, M. Furushima, N. Okada, M. Makino, S. Mizobuchi, S. | J Anesth | 2019 |
Delirium |
Association between delirium, adverse clinical events and functional outcomes in older patients admitted to rehabilitation settings after a hip fracture: A multicenter retrospective cohort study. | Morandi, A. Mazzone, A. Bernardini, B. Suardi, T. Prina, R. Pozzi, C. Gentile, S. Trabucchi, M. Bellelli, G. | Geriatrics & Gerontology International | 2019 |
aged |
Handover of anesthesia care is associated with an increased risk of delirium in elderly after major noncardiac surgery: results of a secondary analysis. | Liu, G. Y. Su, X. Meng, Z. T. Cui, F. Li, H. L. Zhu, S. N. Wang, D. X. | J Anesth | 2019 |
Delirium |
Undiagnosed delirium is frequent and difficult to predict: Results from a prevalence survey of a tertiary hospital. | Lange, P. W. Lamanna, M. Watson, R. Maier, A. B. | J Clin Nurs | 2019 |
Undiagnosed delirium |