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Low-dose haloperidol ineffective against delirium following thoracic surgery

07 Dec 2018

Low-dose administrations of haloperidol after thoracic surgery does not appear to prevent postoperative delirium, according to a new study.

Researchers randomly assigned 135 adults undergoing thoracic surgery to receive either low-dose intravenous haloperidol (0.5 mg thrice daily, 11 total doses; n=68; median age 60 years; 32.4 percent female) or placebo (n=67; median age 62.3 years; 19.4 percent female).

The incidence of delirium was statistically comparable between the haloperidol and placebo groups (22.1 percent vs 28.4 percent; p=0.43). Similarly, there were no significant differences in the time to development of delirium (p=0.43) or the median number of delirium days (p=0.71).

Both groups also showed similar median lengths of stay in the intensive care unit (ICU; haloperidol vs placebo: 2.2 vs 2.3 days; p=0.29) and in the hospital (10 vs 10 days; p=0.40). However, when analysis was restricted to only those with delirium, haloperidol resulted in a significantly shorter median hospital stay (10 vs 11 days; p=0.03).

Researchers then conducted a subgroup analysis on 84 patients undergoing oesophagectomy, of whom 42 received the haloperidol intervention while 42 were given placebo. In these patients, haloperidol demonstrated superiority over placebo at reducing delirium incidence (23.8 percent vs 40.5 percent), but the difference did not reach statistical significance (p=0.16).

Most of the secondary outcomes were similarly comparable: time to delirium (p=0.14), number of days with delirium (p=0.70) and length of hospital stay (p=0.25). In contrast, oesophagectomy patients on haloperidol showed significantly shorter median lengths of ICU stay (2.8 vs 3.1 days; p=0.03).

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