Mehmet Kenan EROL, Firdevs KAY, Nazım KANKILIÇ

The effect of midazolam on delirium in patients undergoing coronary artery bypass surgery

Aim: Delirium is a serious complication seen postoperatively in patients undergoing cardiovascular surgery. In this study, we aimedto investigate the effect of midazolam given preoperatively on the incidence of delirium in the postoperative period in patientsundergoing open heart surgery.Material and Methods: The files of patients who underwent open heart surgery between 2017-2019 in Cardiovascular SurgeryIntensive Care Unit were retrospectively reviewed. 50 patients were included in the study. Ramsey Agitation Sedation Scale (RASS)and Confusion Assessment Method (CAM-ICU) values were recorded preoperatively, before and after extubation, in the ICU (after thefirst 24 hours) and after service transfers. Patients were divided into two groups as midazolam used or midazolam-free.Results: 28 patients were male (56%) and 22 were female (44%). The rate of delirium before extubation (T0) during the ICU stay periodwas significantly higher in the group without midazolam (p = 0.01). Similarly, the rate of delirium after extubation (T1) was found tobe high in the group without midazolam (p = 0.00). There were also significant differences in extubation times. It was found 5.48 ±1.08 hours in the group using midazolam and 8.3 ± 0.69 hours in the group without midazolam (p = 0.00).Conclusion: The use of midazolam in induction and perfusion in patients undergoing cardiopulmonary bypass could reduce thedevelopment of delirium in the postoperative period. Besides, RASS and CAM-ICU evaluation forms could be useful in early detectionand monitoring of postoperative delirium.

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