Postoperative Delirium in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting According to the Anesthetic Agent: A Retrospective Study.

OBJECTIVE

To evaluate the effect of two anesthetic agents (sevoflurane or propofol) on postoperative delirium (POD) in patients undergoing off-pump coronary artery bypass grafting (CABG).

DESIGN

Retrospective observational design.

SETTING

University hospital.

PARTICIPANTS

Two hundred ninety-two patients undergoing off-pump CABG who were anesthetized with sevoflurane or propofol.

METHODS

Incidence of POD, laboratory data, and pre-, intra-, and 24-hour postoperative clinical variables were reviewed retrospectively. The independent predictors of POD were evaluated.

MEASUREMENTS AND MAIN

RESULTS

The cumulative incidence of POD after off-pump CABG was 10.6% (31 of 292 patients) and the incidence rates of POD were not statistically significant in the sevoflurane and propofol groups (13% [20 of 156 patients] and 8% [11 of 136 patients], respectively; p = 0.137). Other variables, including the laboratory and clinical data also did not differ significantly between the anesthetic groups. Age ≥75 years (odds ratio [OR], 4.84; 95% confidence interval [CI], 1.44-16.27; p = 0.011), postoperative pneumonia (OR, 10.84; 95% CI, 3.32-35.34; p < 0.001), 6 or more packed red blood cell units transfusion in the first 24 hours postoperatively (OR, 5.30; 95% CI, 1.32-21.27; p = 0.019), and 24-hour postoperative albumin <3.0 g/dL (OR, 3.38; 95% CI, 1.20-9.31; p = 0.021) were independent predictors of POD after off-pump CABG.

CONCLUSIONS

The incidence of POD in patients undergoing off pump-CABG did not differ between those receiving sevoflurane versus propofol-based anesthesia.