The objective of this study is to reduce the incidence of postoperative delirium after cardiac surgery in the elderly patient. This proposal is a clinical trial designed to reduce delirium in patients undergoing cardiac surgery by replacing standard postoperative sedation protocols (propofol, midazolam, opioids) with a new alpha2-adrenergic receptor agonist (dexmedetomidine) possessing sedative, analgesic, and antinociceptive properties. Resource utilization analysis will be performed to determine cost effectiveness of the new treatment modality.
The proposed study will be a prospective, randomized, open label study comparing multimodal protocols for postoperative sedation after cardiac surgery. Patients will be randomly allocated to either dexmedetomidine or propofol (control) groups according to a computer generated randomization code in predetermined size blocks of four.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
185
Upon arrival to ICU patients will receive a propofol 2-6mg/kg infusion until tracheal extubation
Upon arrival to ICU patients will receive dexmedetomidine bolus of 0.4mcg/kg followed by an infusion of 0.2-0.7mcg/kg per hour for a maximum period of 24 hours.
University Health Network
Toronto, Ontario, Canada
Dichotomous outcome, a number of patients with delirium in the two study groups.
Assessment of delirium will be performed utilizing the CAM-ICU
Time frame: up to 7 days postoperatively or discharge
The total cost for each patient
Summation of direct-variable, direct-fixed, and overhead costs
Time frame: Up to 7 days or discharge
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