The Efficacy of Oral Risperidone Solution to Reduce the Incidence and Severity of Postoperative Delirium After Vascular Surgery: A Randomized Controlled Trial

Varit  Rangsaritwutikul; Panate  Pukrittayakamee; Tachawan  Jirativanont; Aphichat  Suphathamwit; Tanamate  Chaibanjongwat; Orawan  Pongraweewan

doi:10.33192/smj.v77i10.276806

Authors

Varit Rangsaritwutikul Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Panate Pukrittayakamee Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Tachawan Jirativanont Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Aphichat Suphathamwit
Tanamate Chaibanjongwat Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Orawan Pongraweewan Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v77i10.276806

Keywords:

Vascular surgery, Postoperative delirium, Risperidone

Abstract

Objective: To determine the efficacy of the preoperative oral solution of risperidone in preventing Postoperative delirium (POD) and reducing the severity of POD in patients with geriatric vascular disease.

Materials and Methods: Randomized, double-blind, placebo controlled trial. A total of 140 elderly patients scheduled for vascular surgery were enrolled and randomly assigned to either the risperidone group (0.5 mg oral solution of risperidone within 1 hour before surgery) or the placebo group.

Results: POD was assessed daily using the DSM-5 criteria, and its severity was measured with the Delirium Rating Scale (DRS) for the first three days after surgery. The incidence and severity of POD were compared between the two groups. Potential side effects of risperidone, and the length of hospital stay were also recorded. There were no statistical differences in demographic data between the two groups. The incidence of POD was 10.6% compared to 21.2 % in the intervention group without statistical significance (p-value=0.096). However, the severity of POD, measured by the DRS, was significantly lower in the risperidone group (2.0 vs. 6.0, p value=0.025). The length of hospital stay did not show significant differences between the two groups.

Conclusions: The overall incidence of POD in this study without intervention was 21.2%. Preoperative administration of oral risperidone (0.5mg) reduced the severity of POD, but did not affect the incidence of POD or the length of hospital stay in this population.

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