Dexmedetomidine: magic bullet or firing blanks?

Postoperative delirium (POD) is a major source of morbidity after both cardiac and major non-cardiac surgery. It is common, occurring in 4–54% of patients, depending on patient’s age, comorbidities, and type of surgery (1). POD is linked to accelerated functional decline, and an increase in relative risk of death by 10–20% for every 48 hours of duration of POD (2). Potential practices for reducing the incidence and severity of POD are therefore a major area of active research during the perioperative period. A recently published randomised controlled trial by Su et al. (3) has shed new light on the place of dexmedetomidine for POD prophylaxis.