Preventive Effect of Suvorexant for Postoperative Delirium after Coronary Artery Bypass Grafting

Ann Thorac Cardiovasc Surg. 2019 Feb 20;25(1):26-31. doi: 10.5761/atcs.oa.18-00038. Epub 2018 Aug 9.

Abstract

Objective: Suvorexant is an orexin receptor antagonist and is effective in inducing sleep. We hypothesized that Suvorexant would reduce the incidence of postoperative delirium (POD) after coronary artery bypass grafting (CABG).

Methods: We reviewed 88 patients (12 women, mean age: 69.3 ± 2.5 years) who were undergone CABG alone. Patients were divided into two groups; patients received Suvorexant (S group, n = 36), patients not received Suvorexant (N group, n = 52), and the following data were analyzed and compared between two groups.

Results: Intensive Care Unit Delirium Screening Checklist Score was significantly lower in S group compared with N group (N:S = 2.0 ± 1.7:0.8 ± 1.0, p = 0.0003). Although POD was present in 11 of 52 patients (21.2%) in N group, one patient (2.8%) developed in S group (p = 0.008). In S group, both intensive care unit stay (N:S = median 6:5 days, p = 0.001) and hospital stay (N:S = median 23:20 days, p = 0.035) were significantly shorter than in N group.

Conclusions: Suvorexant might reduce incidence of POD in patients undergone CABG.

Keywords: Suvorexant; coronary artery bypass grafting; orexin receptor antagonist; postoperative delirium.

MeSH terms

  • Aged
  • Azepines / administration & dosage*
  • Azepines / adverse effects
  • Checklist
  • Coronary Artery Bypass / adverse effects*
  • Delirium / diagnosis
  • Delirium / prevention & control*
  • Delirium / psychology
  • Drug Administration Schedule
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Orexin Receptor Antagonists / administration & dosage*
  • Orexin Receptor Antagonists / adverse effects
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Triazoles / administration & dosage*
  • Triazoles / adverse effects

Substances

  • Azepines
  • Orexin Receptor Antagonists
  • Triazoles
  • suvorexant