Comparison of the Effect of intravenous Acetaminophen and oral Acetaminophen in the Prevention of Delirium in the Elderly After Heart Surgery

Comparison of the effect of intravenous acetaminophen and oral acetaminophen in the prevention of delirium in the elderly after heart surgery

Clinical trial with control group, with parallel groups, double-blind, randomized, phase 3 on 64 patients. Random Allocation Software was used for randomization

Patients undergoing heart surgery referred to Fatemeh Zahra Hospital in Sari, both blind, in which the researcher, patient, nurse, injector and analyzer are blinded and receive the drug in sealed envelopes

Inclusion criteria: Patients who are at least 60 years old and undergo heart surgery Exclusion criteria: preoperative ventricular ejection fraction less than 30%, emergency procedure, aortic dissection surgery, pre-existing cognitive dysfunction, Parkinson's disease, Alzheimer's disease, recent seizures (less than 3 months), use of prophylactic drugs to reduce Cognitively, serum creatinine is more than 2 mg / dL, liver dysfunction (liver enzymes more than four times the base), alcohol or drug abuse (more than 10 drinks per week), sensitivity to any of the drugs studied

Groups are divided into groups A (intravenous acetaminophen), B (oral acetaminophen). Patients in group A are given 1 gram of intravenous acetaminophen within one hour after hospitalization in the ICU and every 8 hours after surgery and continue until the first 48 hours after surgery. A total of 6 doses are given. Have 500 mg of oral acetaminophen every 6 hours for 48 hours for a total of 8 postoperative doses. Both groups also receive painkillers (morphine). Oral placebo 500 mg every 6 hours used in this study and intravenous placebo is the same as normal saline 0.9% used every 8 hours for the patient

Delirium prevention, pain control

The random assignment process will be assigned to two groups in blocks. A and B are 16 blocks of 4 and the Random Allocation software is used. The drugs are similar in appearance and volume and are responsible for preparation. The tablets for each group, which are similar in appearance, were prepared in another room and delivered to the person in charge in the operating room. Taber was injected into the patient according to the randomization block and random letters A and B without knowing the type of drug.

The injecting nurse and the patient in charge of data collection are kept blind due to the fact that the drugs have a similar appearance and are prepared in another room and delivered to the nurse in sealed envelopes for bilateral blinding of patients into two groups of 32 people. Divided, one hour after admission to the ICU of the first group (A) 1 gram of intravenous acetaminophen and oral placebo to the second group (B) 500 mg of oral acetaminophen and 1 gram of intravenous placebo is administered. They do not have two groups