A Study of the Prophylactic and Curative Effect of Melatonin on Postoperative Delirium after Coronary Artery Bypass Grafting Surgery in Elderly Patients

Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 72, Issue 7

Abstract

<strong>Background: </strong>delirium is a common complication after cardiac surgical procedures and is associated with increased morbidity and mortality. Postoperative delirium is associated with an increased length of stay in the intensive care unit, long hospital stay and high hospital charges. <strong>Aim of the Work:</strong> to investigate the effectiveness of melatonin as a preoperative sedative as well as the preventive and the curative effect of melatonin supplementation in elderly patients undergoing coronary artery bypass surgery on postoperative delirium. <strong>Patients and Methods:</strong> this prospective, randomized, controlled, double blind study was conducted on a total of 50 patients allocated into 2 equal groups. It was conducted in Ain Shams University hospitals, in the cardiothoracic surgery unit. <strong>Results:</strong> melatonin has superior sedative effect at 30 min preoperatively compared with placebo (P=0.022). Melatonin succeeded to treat about 56% of delirious patients. The incidence of delirium was 8% in the melatonin group vs. 28% in the control group (P= 0.046). In univariate analysis, predictors of delirium in both groups were age (P= 0.049 in melatonin group, P=0.021 in control group), higher fentanyl dose (P= 0.021 in melatonin group, P=0.047 in control group), lower ejection fraction (P= 0.018 in melatonin group, P=0.008 in control group), longer cardiopulmonary bypass (CPB) times (P= 0.026 in melatonin group, P=0.04 in control group) and longer aortic cross clamping (ACC) times (P= 0.04 in melatonin group, P=0.019 in control group). <strong>Conclusion:</strong> administration of melatonin significantly decreased the incidence of postoperative delirium (POD) after coronary artery bypass grafting in elderly patients and significantly increased preoperative sedation. Advanced age, higher total intraoperative fentanyl dose, lower ejection fraction and longer CPB and ACC times were independent predictors of POD with or without melatonin supplementation. 

Authors and Affiliations

Eman Helal

Keywords

Related Articles

TMPRSS6 Gene Polymorphism and Serum Hepcidin in Iron Deficiency Anemia

Background: Iron deficiency anemia (IDA) is a global health problem and common medical condition seen in everyday clinical practice. Hepcidin which is the key regulator of iron homeostasis, that down-regulates iron expor...

Monitoring of Free Living Amoeba in Some Drinking Water Treatment Plant in Great Cairo Governorate, Egypt

<span>Background: </span><span>Free-living amoebae (FLAs) in drinking water exerts an indirect public health hazards as they may harbor pathogenic microorganisms that can escape drinking water treatment processes and rea...

Cerebrovascular Stroke among Senior Adult Population in Arar, KSA

<span>Background: </span><span>In the Kingdom of Saudi Arabia, stroke is a rapidly growing problem and a major cause of illness and death. This increasing incidence is due to the changing life style in the country and hi...

Predictive and Prognostic Impact of Tumor-Infiltrating Lymphocytes (CD8+) In Breast Cancer Treated With Neoadjuvant Chemotherapy

<strong>Background and Objectives:</strong> the use of neoadjuvant chemotherapy (NAC) in breast cancer induces a pCR in only 30–35% of patients. We can’t depend only on clinical and pathological factors to distinguish th...

Systemic Versus Intratympanic Corticosteroid Therapy for Idiopathic Sudden Sensorineural Hearing Loss; A Meta-analytical Study

<strong>Background:</strong> idiopathic sudden sensorineural hearing loss (ISSHL) is one of the most controversial issues in otology. There have been countless publications and debates concerning ISSHL over the last deca...

Download PDF file
  • EP ID EP584261
  • DOI 10.12816/ejhm.2018.10174
  • Views 152
  • Downloads 0

How To Cite

Eman Helal (2018). A Study of the Prophylactic and Curative Effect of Melatonin on Postoperative Delirium after Coronary Artery Bypass Grafting Surgery in Elderly Patients. The Egyptian Journal of Hospital Medicine, 72(7), 4919-4926. https://www.europub.co.uk/articles/-A-584261