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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.
Fang et al. (Sat,) studied this question.