Abstract 4145368: Dexmedetomidine for prevention of postoperative delirium in patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials

Background: Postoperative delirium is a prevalent complication following cardiac surgery. In recents studies, dexmedetomidine has been proposed as a potential alternative to mitigate this condition. This meta-analysis aimed to evaluate the efficacy of dexmedetomidine for prevention of postoperative delirium after cardiac surgery. Methods: We systematically searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) analyzing the efficacy of dexmedetomidine compared to placebo in patients undergoing cardiac surgeries. We pooled risk ratios (RR) for binary outcomes with 95% confidence intervals (CI) with a random-effects model. We used R version 4.3.2 for all statistical analyses. Results: Our meta-analysis included 12 RCTs comprising 3016 patients, of whom 1515 (50.2%) were randomized to dexmedetomidine. The mean age ranged from 43 to 74 years among studies. Compared with placebo, dexmedetomidine significantly reduced the incidence of postoperative delirium (RR 0.67; 95% CI: 0.48 to 0.95; p<0.05; Figure A). However, there were no significant differences in hypotension (RR 1.34; 95% CI: 0.75 to 2.42; p=0.33; Figure B), and death (RR 0.83; 95% CI: 0.45 to 1.53; p=0.54; Figure C) between groups. Conclusion: In patients undergoing cardiac surgery dexmedetomidine significantly reduced the incidence of postoperative delirium. Larger RCTs are warranted to validate these results.