Effect of Perioperative Low-Dose Dexmedetomidine on Postoperative Delirium After Living-Donor Liver Transplantation: A Randomized Controlled Trial

Background: Postoperative delirium after liver transplantation (LT) is associated with increased hospital length of stay and higher morbidity and mortality. Dexmedetomidine is a recommended and widely used sedative in critically ill patients with reports of potential for delirium prevention. Methods: A randomized controlled clinical trial was performed to investigate whether perioperative low-dose dexmedetomidine infusion would decrease delirium after living-donor LT. Dexmedetomidine (0.1 mcg/kg/hour) was administered during anesthesia and through postoperative day 2 for patients in the dexmedetomidine group, whereas 0.9% saline was administered at the same rate for the same duration for patients in the control group. The incidence of delirium after LT was compared between the 2 groups. Delirium duration, mechanical ventilation duration, intensive care unit (ICU) and hospital length of stay, and in-hospital and 3-month mortality were also compared. Results: There was no significant difference in delirium incidence in the dexmedetomidine group compared to the control group (9% vs 5.9%; P =.44). Duration of delirium and mechanical ventilation, ICU and hospital length of stay, and in-hospital and 3-month mortality were comparable between the 2 groups. Conclusions: Perioperative low-dose dexmedetomidine infusion did not reduce the incidence of delirium in living-donor LT.