The Effect of Zolpidem or Promethazine Premedication on Agitation, Sedation and Cognitive Disorders before and after Coronary Artery Bypass Graft Surgery

Lack of control of agitation and patient’s pain before and after coronary artery bypass graft surgery (CABG) can cause severe and irrecoverable complications. Till the time of our study، there was no study to compare the effects of two drugs premedication، zolpidem and promethazine، in agitation، sedation and cognitive problems before and after coronary artery bypass graft surgery; we decided to do this. The study was a double-blind clinical trial on 85 patients undergoing coronary artery bypass graft in the age-range of 40 to 70 years. The subjects were divided in two groups receiving zolpidem or promethazine. The hemodynamic status، analysis of arterial blood gas، scale of sedation and agitation (SAS) and Clock Drawing Test (CDT) were checked before coronary artery bypass graft surgery، in Intensive Care Unit (ICU) and at the time of discharge. Sedation was higher and agitation was lower in zolpidem group before coronary artery bypass graft surgery and the differences were significant (P = 0. 019). The score of zolpidem group was significantly more in clock drawing test before the surgery (P = 0. 043). According to this study، patients who received zolpidem، had more sedation and less agitation than the promethazine group and cognitive disorder was less in them. Keywords: Zolpidem، Promethazine، Premedication، Coronary artery bypass graft surgery (CABG)، Agitation، Cognitive disorder