Morphine is a reasonable alternative to haloperidol in the treatment of postoperative hyperactive-type delirium after cardiac surgery

Abstract

Objectives: Patients who undergo cardiac surgery have an increased risk of delirium. Currently, there are few choices of treatment for postoperative hyperactive delirium in cardiac surgical patients. The aim of this study was to assess the effect of morphine compared with a haloperidol-based regimen in hyperactive-type delirium in patients after cardiac surgery.

Design: A prospective, randomized clinical study.

Setting: A single community hospital.

Participants: Fifty-three consecutive, adult, delirious patients.

Interventions: Patients were randomized into 2 groups; in group 1, patients received 5mg of haloperidol intramuscularly and in group 2, patients received 5mg of morphine sulfate intramuscularly to control delirium symptoms.

Measurements and main results: During the second and third hour of the morphine treatment, statistically low Richmond Agitation and Sedation Scale scores were found and the target Richmond Agitation and Sedation Scale scores percentages were statistically higher than those of the haloperidol group (p = 0.042 and p = 0.028, respectively). The number of patients requiring additive sedatives was significantly more in the haloperidol group when compared with the morphine group (p = 0.011).

Conclusion: During the treatment of patients, it was determined that the patients who were receiving morphine treatment responded more quickly compared with the patients receiving haloperidol treatment. Morphine was found to be a reasonable alternative to haloperidol in the treatment of postoperative hyperactive delirious patients after cardiac surgery.

Keywords: cardiac surgery; delirium; haloperidol; intensive care unit (ICU); morphine; treatment.