{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T21:19:11Z","timestamp":1794259151882,"version":"4.9.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The aim of this clinical study was to evaluate the efficacy of neurobehavioral, hemodynamics and sedative characteristics of dexmedetomidine compared with morphine and midazolam-based regimen after cardiac surgery at equivalent levels of sedation and analgesia in improving clinically relevant outcomes such as delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Sixty patients were randomly allocated into one of two equal groups: group A = 30 patients received dexmedetomidine infusion (0.4\u20130.7 \u03bcg\/kg\/h) and Group B = 30 patients received morphine in a dose of 10\u201350 \u03bcg\/kg\/h as an analgesic with midazolam in a dose of 0.05 mg\/kg up to 0.2 mg\/kg as a sedative repeated as needed. Titration of the study medication infusions was conducted to maintain light sedation (Richmond agitation-sedation scale) (\u22122 to +1). Primary outcome was the prevalence of delirium measured daily through confusion assessment method for intensive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Group A was associated with shorter length of mechanical ventilation, significant shorter duration of intensive care unit (ICU) stay (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.038), and lower risk of delirium following cardiac surgery compared to Group B. Group A showed statistically significant decrease in heart rate values 4 h after ICU admission (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.015) without significant bradycardia. Group A had lower fentanyl consumption following cardiac surgery compared to Group B.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Dexmedetomidine significantly reduced the length of stay in ICU in adult cardiac surgery with no significant reduction in the incidence of postoperative delirium compared to morphine and midazolam.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_303_17","type":"journal-article","created":{"date-parts":[[2018,3,8]],"date-time":"2018-03-08T23:57:08Z","timestamp":1520553428000},"page":"190-197","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":45,"title":["Dexmedetomidine vs morphine and midazolam in the prevention and treatment of delirium after adult cardiac surgery; a randomized, double-blinded clinical trial"],"prefix":"10.4103","volume":"12","author":[{"given":"Tamer M. Abdel","family":"Azeem","sequence":"first","affiliation":[{"name":"Intensive care specialist at Intensive Care Department of Dar El Fouad Hospital, Ain-shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahed E.","family":"Yosif","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Ain-shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel M.","family":"Alansary","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Ain-shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim Mamdouh","family":"Esmat","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Ain-shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed K.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Ain-shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R3-20250920","first-page":"157","article-title":"Evaluation of the prevalence and risk factors of delirium in cardiac surgery ICU","volume":"5","author":"Shadvar","year":"2013","journal-title":"J Cardiovasc Thorac Res"},{"key":"R4-20250920","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.ejcnurse.2010.09.001","article-title":"Risk factors of delirium after cardiac surgery: A systematic review","volume":"10","author":"Koster","year":"2011","journal-title":"Eur J Cardiovasc Nurs"},{"key":"R5-20250920","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1017\/S1041610213002433","article-title":"The association between C-reactive protein and delirium in 710 acute elderly hospital admissions","volume":"26","author":"Ritchie","year":"2014","journal-title":"Int Psychogeriatr"},{"key":"R6-20250920","doi-asserted-by":"crossref","first-page":"R169","DOI":"10.1186\/cc11646","article-title":"Can dexmedetomidine be a safe and efficacious sedative agent in post-cardiac surgery patients? 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