Effects of Preoperative Quetiapine on Postoperative Delirium in Coronary Artery Bypass Graft Surgery Patients: A Randomized Double-blind Controlled Trial

Background: Coronary artery bypass graft (CABG) is a lifesaving surgery; however, it can be accompanied by potential adverse events, such as post-operative delirium (POD). Objectives: The aim of this study was to evaluate the effects of quetiapine on POD in patients undergoing CABG. Materials & Methods: This randomized clinical trial was carried out from December 2023 to November 2024 in an academic center affiliated with the Guilan University of Medical Sciences (GUMS). Eligible patients were equally divided into two groups of quetiapine and control. POD was assessed using the confusion assessment method (CAM) in the intensive care unit (ICU) every 12 hours for two days postoperatively. Results: Data from 82 CABG patients were analyzed. No significant difference was found between the two quetiapine and control groups regarding patients’ demographic data and surgery characteristics (P>0.05). Two cases in the quetiapine group (4.87%) and four patients in the control group (9.75%) developed POD, with no significant difference (P=0.675). Comparing the onset time of delirium in the quetiapine (9.5±0.7) and control (8.5±0.57) groups, no significant difference was observed (P=0.135). There was no association between patients’ co-morbidities (P=0.675), American Society of Anesthesiologists (ASA) class (P=0.154), age (P=0.648), body mass index (BMI) (P=0.468), and the occurrence of POD. None of our cases showed serious adverse effects. Conclusion: Quetiapine can be used safely in CABG patients with promising results, despite the lack of statistical difference. In this regard, well-planned trials with sufficient sample sizes and higher dosages are encouraged to achieve practical results.