Effect of Intraoperative Midazolam on Postoperative Delirium in Older Surgical Patients: A Prospective, Multicenter Cohort Study
Midazolam is a short-acting benzodiazepine frequently used in the perioperative setting. This study aimed to investigate the potential impact of intraoperative midazolam on postoperative delirium in older patients undergoing noncardiac surgery. This study included patients aged 65 yr and older who r...
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| Vydané v: | Anesthesiology (Philadelphia) Ročník 142; číslo 2; s. 268 |
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| Hlavní autori: | , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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United States
01.02.2025
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| ISSN: | 1528-1175 |
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| Abstract | Midazolam is a short-acting benzodiazepine frequently used in the perioperative setting. This study aimed to investigate the potential impact of intraoperative midazolam on postoperative delirium in older patients undergoing noncardiac surgery.
This study included patients aged 65 yr and older who received general anesthesia between April 2020 and April 2022 in multiple hospitals across China. Postoperative delirium occurring within 7 days was assessed using the 3-min Diagnostic Interview for Confusion Assessment Method. Univariable and multivariable logistic regression models based on the random effects were used to determine the association between midazolam administration and the occurrence of postoperative delirium, presented as the risk ratio and 95% CI. A Kaplan-Meier cumulative incidence curve was plotted to compare the distribution of time to postoperative delirium onset between patients who received midazolam and those who did not. Subgroup analyses based on specific populations were performed to explore the relationship between midazolam and postoperative delirium.
In all, 5,663 patients were included, of whom 723 (12.8%) developed postoperative delirium. Univariate and multivariable logistic regression analyses based on random effects of different hospitals showed no significant association between midazolam medication and postoperative delirium among older population (unadjusted risk ratio, 0.96; 95% CI, 0.90 to 1.30; P = 0.38; and adjusted risk ratio, 1.09; 95% CI, 0.91 to 1.33; P = 0.35). The Kaplan-Meier curve showed no difference in the distribution of time to postoperative delirium onset (hazard ratio, 1.02; 95% CI, 0.88 to 1.18; P = 0.82). The results of subgroup analyses found that intraoperative midazolam treatment was not associated with postoperative delirium in the specific subgroups of patients.
Intraoperative administration of midazolam may not be associated with an increased risk of postoperative delirium in older patients undergoing noncardiac surgery. |
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| AbstractList | Midazolam is a short-acting benzodiazepine frequently used in the perioperative setting. This study aimed to investigate the potential impact of intraoperative midazolam on postoperative delirium in older patients undergoing noncardiac surgery.
This study included patients aged 65 yr and older who received general anesthesia between April 2020 and April 2022 in multiple hospitals across China. Postoperative delirium occurring within 7 days was assessed using the 3-min Diagnostic Interview for Confusion Assessment Method. Univariable and multivariable logistic regression models based on the random effects were used to determine the association between midazolam administration and the occurrence of postoperative delirium, presented as the risk ratio and 95% CI. A Kaplan-Meier cumulative incidence curve was plotted to compare the distribution of time to postoperative delirium onset between patients who received midazolam and those who did not. Subgroup analyses based on specific populations were performed to explore the relationship between midazolam and postoperative delirium.
In all, 5,663 patients were included, of whom 723 (12.8%) developed postoperative delirium. Univariate and multivariable logistic regression analyses based on random effects of different hospitals showed no significant association between midazolam medication and postoperative delirium among older population (unadjusted risk ratio, 0.96; 95% CI, 0.90 to 1.30; P = 0.38; and adjusted risk ratio, 1.09; 95% CI, 0.91 to 1.33; P = 0.35). The Kaplan-Meier curve showed no difference in the distribution of time to postoperative delirium onset (hazard ratio, 1.02; 95% CI, 0.88 to 1.18; P = 0.82). The results of subgroup analyses found that intraoperative midazolam treatment was not associated with postoperative delirium in the specific subgroups of patients.
Intraoperative administration of midazolam may not be associated with an increased risk of postoperative delirium in older patients undergoing noncardiac surgery. |
| Author | Mao, Meng-Meng Cao, Jiang-Bei Duan, Chong-Yang Li, Hao Mi, Wei-Dong Yang, Yu Lou, Jing-Sheng Sun, Jing-Jia Xu, Jun-Mei Wu, Qing-Ping Wang, Di-Fen Liu, Chang Liu, Yan-Hong |
| Author_xml | – sequence: 1 givenname: Hao surname: Li fullname: Li, Hao organization: Department of Anaesthesiology, First Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China; Medical School of Chinese PLA General Hospital, Beijing, China; and National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China – sequence: 2 givenname: Chang surname: Liu fullname: Liu, Chang organization: School of Medicine, Nankai University, Tianjin, China; Department of Anaesthesiology, First Medical Centre, Chinese PLA General Hospital, Beijing, China; and National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China – sequence: 3 givenname: Yu surname: Yang fullname: Yang, Yu organization: Department of Anaesthesiology, First Medical Centre, Chinese PLA General Hospital, Beijing, China – sequence: 4 givenname: Qing-Ping surname: Wu fullname: Wu, Qing-Ping organization: Department of Anaesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China – sequence: 5 givenname: Jun-Mei surname: Xu fullname: Xu, Jun-Mei organization: Department of Anaesthesiology, Second Xiangya Hospital, Central South University, Changsha, China – sequence: 6 givenname: Di-Fen surname: Wang fullname: Wang, Di-Fen organization: Department of Critical Care Medicine, Affiliated Hospital of Guizhou Medical University, Guiyang, China – sequence: 7 givenname: Jing-Jia surname: Sun fullname: Sun, Jing-Jia organization: Department of Anaesthesiology, First Medical Centre, Chinese PLA General Hospital, Beijing, China – sequence: 8 givenname: Meng-Meng surname: Mao fullname: Mao, Meng-Meng organization: Department of Anaesthesiology, First Medical Centre, Chinese PLA General Hospital, Beijing, China – sequence: 9 givenname: Jing-Sheng surname: Lou fullname: Lou, Jing-Sheng organization: Department of Anaesthesiology, First Medical Centre, Chinese PLA General Hospital, Beijing, China; and Medical School of Chinese PLA General Hospital, Beijing, China – sequence: 10 givenname: Yan-Hong surname: Liu fullname: Liu, Yan-Hong organization: Department of Anaesthesiology, First Medical Centre, Chinese PLA General Hospital, Beijing, China; and Medical School of Chinese PLA General Hospital, Beijing, China – sequence: 11 givenname: Jiang-Bei surname: Cao fullname: Cao, Jiang-Bei organization: Department of Anaesthesiology, First Medical Centre, Chinese PLA General Hospital, Beijing, China; and Medical School of Chinese PLA General Hospital, Beijing, China – sequence: 12 givenname: Chong-Yang surname: Duan fullname: Duan, Chong-Yang organization: Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China – sequence: 13 givenname: Wei-Dong surname: Mi fullname: Mi, Wei-Dong organization: Department of Anaesthesiology, First Medical Centre, Chinese PLA General Hospital, Beijing, China; Medical School of Chinese PLA General Hospital, Beijing, China; School of Medicine, Nankai University, Tianjin, China; and National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China |
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| Snippet | Midazolam is a short-acting benzodiazepine frequently used in the perioperative setting. This study aimed to investigate the potential impact of intraoperative... |
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| SubjectTerms | Aged Aged, 80 and over Anesthesia, General China - epidemiology Cohort Studies Delirium - chemically induced Delirium - epidemiology Emergence Delirium - chemically induced Emergence Delirium - epidemiology Female Humans Hypnotics and Sedatives - administration & dosage Hypnotics and Sedatives - adverse effects Intraoperative Care - methods Male Midazolam - administration & dosage Midazolam - adverse effects Postoperative Complications - chemically induced Postoperative Complications - epidemiology Prospective Studies |
| Title | Effect of Intraoperative Midazolam on Postoperative Delirium in Older Surgical Patients: A Prospective, Multicenter Cohort Study |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/39470760 |
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