Efficacy and safety of gastrodin in preventing postoperative delirium following cardiac surgery: a randomized placebo controlled clinical trial.

Summary

In a double-blind RCT of 155 CABG patients, gastrodin infusion (600 mg twice daily through POD6) reduced postoperative delirium incidence from 35.9% to 19.5% and increased odds of hospital discharge without drug-related adverse events. POCD incidence was low and similar between groups.

Key Findings

• Postoperative delirium incidence reduced to 19.5% with gastrodin versus 35.9% with placebo (RR 0.54, 95% CI 0.32–0.93).
• No increase in adverse events; none were drug related (9.1% vs 14.1%).
• Greater odds of discharge in the gastrodin group (subhazard ratio 1.20, 95% CI 1.00–1.84).

Clinical Implications

Gastrodin infusion may be considered as a prophylactic adjunct for delirium in CABG patients pending replication, with monitoring protocols and inclusion in multimodal delirium prevention bundles.

Limitations

• Single-country, single drug regimen; generalizability beyond CABG ± valve surgery is uncertain.
• Sample size modest; POCD outcomes were rare, limiting power for cognitive endpoints.

Future Directions

Multicenter, larger RCTs across cardiac and non-cardiac surgeries, dose–response assessments, mechanistic studies (GABAergic/anti-inflammatory pathways), and health economic evaluations.