Objective To observe the effects of early comfort using analgesia, minimal sedatives and maximal humane care (eCASH) on postoperative delirium and adverse events in patients undergoing cardiovascular surgery.
Methods A total of 94 patients undergoing cardiovascular surgery in the First People's Hospital of Shangqiu from October 2019 to October 2022 were randomly divided into conventional group and eCASH intervention group 47 patients in each group. Postoperative delirium, stress indexes substance P (SP), prostaglandin E2 (PGE2) and delirium-included adverse events, and recovery were compared between the two groups.
Results The incidence of delirium in the eCASH intervention group was lower than that in the conventional group (10.64% vs. 29.79%, P=0.021), and the duration of delirium was shorter than that in the conventional group (2.47±1.23 vs. 4.02±1.15, P<0.001). The serum levels of SP (6.42±1.28 vs. 9.65±2.33, P<0.001) and PGE2 (112.56±23.21 vs. 140.26±18.32, P<0.001) in the eCASH intervention group 3 days after surgery were lower than those in the conventional group. The incidence of total adverse events in the eCASH intervention group was lower than that in the conventional group, and the duration of mechanical ventilation, ICU stay, bed rest and hospital stay were shorter than those in the conventional group (P<0.05).
Conclusion eCASH may effectively reduce delirium and adverse events in patients after cardiovascular surgery, and improve stress state.
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