Effects of short-term preoperative intranasal dexmedetomidine plus conventional treatment on delirium following cardiac surgery in patients with sleep disorders

Abstract Study objectives To assess whether preoperative dexmedetomidine (DEX) nasal drips combined with conventional treatment could mitigate the occurrence of postoperative delirium (POD). Design A prospective randomised controlled study. Setting The cardiac surgery intensive care unit (CSICU) and patient hospitalisation ward at a university hospital. Participants A total of 100 patients (aged ≥60 years) undergoing cardiac surgery at a university hospital between 7 January 2022, and 30 November 2022 met the eligibility criteria and were included in the study. Interventions Patients with sleep disorders (Pittsburgh Sleep Quality Index ≥8) were divided into two groups: Group A (the placebo group, n =50), receiving a short-term preoperative placebo combined with conventional treatment and Group B (the DEX group, n =50), receiving short-term preoperative DEX combined with conventional treatment. Measurements and results The Confusion Assessment Method for the ICU (CAM-ICU) was used for POD assessment in the CSICU, while the CAM was employed to assess delirium in the patient ward. Group B demonstrated a reduced incidence of POD compared to Group A (12% vs. 30%, odds ratio: 0.318, 95% confidence interval: 0.112–0.905, p =0.027). Conclusion The combined treatment involving DEX demonstrated a decreased incidence of POD in elderly individuals with sleep disorders undergoing cardiac surgery compared to the placebo combination treatment. Trial registration URL: www.chictr.org.cn with registration number ChiCTR 2100043968, registered on 06/03/2021.