Comparison of dexmedetomidine or ondansetron with haloperidol for treatment of postoperative delirium in trauma patients admitted to intensive care unit: randomized controlled trial

Abstract

Objective: This study was designed to compare the effect of dexmedetomidine or ondansetron with
haloperidol, as a control, for the treatment of postoperative delirium in trauma patients.
Methodology: A total of 96 adult trauma patients diagnosed with postoperative delirium were randomized
into three equal groups. Patients were given either 1 μg/kg dexmedetomidine (Dexmed group) or 4 mg
ondansetron (Ondan group) or 5 mg haloperidol (Halo group), administered twice daily for 3 consecutive
days. Number of delirious patients, patients who needed “rescue haloperidol” and the total amount of
“rescue haloperidol” during study period was calculated.
Results: At the end of the study, the number of remaining delirious patients was 3, 6, and 2 in Dexmed,
Ondan, and Halo groups, respectively, without statistical significance. During the study period, there was
no significant difference in the number of patients who needed “rescue haloperidol” between Dexmed
and Halo groups (5 vs. 3; p = 0.7). However, the difference was significantly higher in Ondan group
compared to Halo group (11 vs. 3; p = 0.03). The mean total “rescue haloperidol” dose was significantly
higher in Ondan group compared to Halo group (p < 0.001), but there was no difference between
Dexmed and Halo groups (p = 0.07). At the same time of delirium assessment, mean arterial blood
pressure and mean score on Visual Analog Scale were not statistically different between Dexmed or
Ondan group versus Halo group. No serious adverse events were reported.
Conclusion: Dexmedetomidine is a potential alternative treatment for postoperative delirium in trauma
patients admitted to ICU.