Dexmedetomidine Lowered the Incidence of Postoperative Delirium

In a recent placebo-controlled study, delirium resolved more quickly in delirious patients in the intensive care unit (ICU) who received dexmedetomidine (NEJM JW Gen Med May 15 2016 and JAMA 2016; 315:1455). However, whether this finding was due to a direct effect of dexmedetomidine on delirium or less use of other medications that contribute to delirium is unclear. Investigators in China randomized 700 older patients (age, ≥65) who underwent noncardiac surgery to receive low-dose dexmedetomidine (0.1 µg/kg/hour) or placebo postoperatively. Infusion was initiated shortly after arrival in the ICU in nonintubated patients but was delayed until sedatives were weaned in intubated patients; dexmedetomidine ran overnight on the first postoperativ…