ReviewCanadian journal of anaesthesia = Journal canadien d'anesthesie2011
Contribution of sedative-hypnotic agents to delirium via modulation of the sleep pathway.
Review in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Proposal for Managing Cancer-Related Insomnia: A Systematic Literature Review of Associated Factors and a Narrative Review of Treatment.Cancer medicine · 2024Pooled it
- Music intervention for sleep quality in critically ill and surgical patients: a meta-analysis.BMJ open · 2021Pooled it
- A meta-analysis of sleep-promoting interventions during critical illness.The American journal of medicine · 2015Pooled it
- Postoperative Delirium After Dexmedetomidine versus Propofol Sedation in Older Adults Undergoing Hip Fracture Surgery with Spinal Anesthesia: A Randomized Controlled Trial.Drug design, development and therapy · 2026Trial
- Trial
- Sleep quality of mechanically ventilated patients sedated with dexmedetomidine.Intensive care medicine · 2012Trial
- Cooperative Virtual Reality Gaming for Anxiety and Pain Reduction in Pediatric Patients and Their Caregivers During Painful Medical Procedures: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2025Article
- COVID-19 delirium and encephalopathy: Pathophysiology assumed in the first 3 years of the ongoing pandemic.Brain disorders (Amsterdam, Netherlands) · 2023Review
- Preventing and treating delirium in clinical settings for older adults.Therapeutic advances in psychopharmacology · 2023Review
- Scratching the structure of moral agency: insights from philosophy applied to neuroscience.Frontiers in neuroscience · 2023Review
- Article
- Article
- Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice.Current neuropharmacology · 2021Review
- Dexmedetomidine in prevention and treatment of postoperative and intensive care unit delirium: a systematic review and meta-analysis.Annals of intensive care · 2018Article
- Observational
- Effects of dexmedetomidine on sleep quality of patients after surgery without mechanical ventilation in ICU.Medicine · 2017Observational
- Intensive Care Unit Delirium: A Review of Diagnosis, Prevention, and Treatment.Anesthesiology · 2016Review
- Dexmedetomidine: magic bullet or firing blanks?Journal of thoracic disease · 2016Article
- From Bench to Bedside and Back Again: A Personal Journey with Dexmedetomidine.Anesthesiology · 2016Review
- DEL-FINE: a new tool for assessing the delirogenic properties of drugs of relevance for European pharmacotherapy.Zeitschrift fur Gerontologie und Geriatrie · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
Abstract
purposeTo review the mechanisms of sedative-hypnotic action with respect to the risk of delirium imparted by drugs that act on γ-amino-butyric-acid type A receptors or α(2) adrenoceptors. SOURCE: MEDLINE was searched for relevant articles. PRINCIPAL
findingsDevelopment of the acute confusional state of delirium is associated with longer intensive care unit (ICU) and hospital lengths of stay, significantly higher risk of functional decline, and increased mortality. Disruption of sleep is a modifiable risk factor that may contribute to delirium and cognitive dysfunction in ICU patients. Among the functions of sleep are repair of defective processes and restoration of the brain to a state in which it is ready to acquire new knowledge. It is logical that disruption of these processes may produce acute confusion. Delirium develops through a complex interaction between the patient's baseline vulnerability (patient's predisposing risk factors before hospitalization) and precipitating factors or insults (modifiable events that occur during hospitalization). The latter factors include both sleep disruption and sedation. We present a hypothesis that these two factors are causally linked through effects on memory. Our hypothesis explains why patients randomized to receive an α(2) adrenoceptor agonist are less likely to develop delirium (and the attendant cognitive dysfunction) than those randomized to receive benzodiazepines.
conclusionHerein we present our hypothesis that alternate mechanisms of hypnotic action may differentiate the deleriogenic properties of the two classes of sedatives. Future studies should focus on whether a causal relationship can be established between sedative administration, sleep disruption, and delirium.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.