Tuesday, March 11, 2008

Tuesday March 11, 2008
Efficacy of risperidone for prevention of postoperative delirium in cardiac surgery

Interesting study particularly for folks working in cardio-thoracic ICUs. This randomised, double-blinded, placebo-controlled study was primarily aimed to evaluate the potential of risperidone to prevent postoperative delirium following cardiac surgery with cardiopulmonary bypass. The secondary objective was to explore clinical factors associated with postoperative delirium.

Number: 126 adult patients undergoing elective cardiac surgery with cardiopulmonary bypass were randomly assigned to receive either 1 mg of risperidone or placebo sublingually when they regained consciousness.

The confusion assessment method for intensive care unit was used to assess postoperative delirium.


Results:

  • The incidence of postoperative delirium in the risperidone group was lower than the placebo group (11.1% vs. 31.7% ).
  • Other postoperative outcomes were not statistically different between the groups.
  • Many factors were associated with postoperative delirium. However multiple logistic regression analysis showed a lapse of 70 minutes from the time of opening eyes to following commands and postoperative respiratory failure were independent risk factors.

Conclusion: A single dose of risperidone administered soon after cardiac surgery with cardiopulmonary bypass reduces the incidence of postoperative delirium. Multiple factors tended to be associated with postoperative delirium, but only the time from opening eyes to following commands and postoperative respiratory failure were independent risk factors in this study.



Reference:

Efficacy of risperidone for prevention of postoperative delirium in cardiac surgery - Anest. and Intensive care, Volume 35, No. 5, 2007, 714-719