en Anesthesia Anesthesia Original Research Original Research <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">Delirium is a significant issue for esophagectomy patients, with dexmedetomidine (Dex) showing promise in alleviating this burden. A randomized trial on Dex&#39;s role in post-esophagectomy delirium can enhance care strategies and patient outcomes.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> This randomized, double-blind clinical trial, conducted at Imam Reza Hospital, Tabriz University of Medical Sciences, in Iran in 2022, involved 60 esophagectomy patients. The intervention group received Dex infusion (0.5&thinsp;&mu;g/kg/h), while the control group received normal saline. Postoperatively, patients received analgesia and were monitored for delirium incidence over 3 days in the intensive care unit (ICU) using the Confusion Assessment Method. This study utilized an independent-sample t test, the Mann-Whitney U test, the &chi;2 test, and the Kaplan-Meier survival analysis with a log-rank test for data comparisons.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results:</b> Delirium in the ICU over 3 days after surgery was significantly lower in the intervention group (10%, n=3) compared with the control group (20%, n=6) (relative risk, 0.62 [95% CI, 0.42-0.98]; </span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal">=0.036). On the first day, no delirium cases occurred in the intervention group, contrasting with 2 cases in the control group (</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal">=0.014). Similarly, on the second day, one case was observed in the intervention group versus 2 in the control group (</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal">=0.042). On the third day, 2 cases were recorded in the intervention group versus 3 in the control group (</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal">=0.031).</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion: </b>The significant reduction in delirium occurrence observed in patients receiving intraoperative Dex infusion highlights its potential as a preventive strategy for postoperative delirium in ICU patients after esophagectomy.</span></span></span></span></span></span></span></span><br> &nbsp; Intraoperative, Dex, Delirium, Esophagectomy, Intensive Care Unit 154 161 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-8797-1&slc_lang=en&sid=1 Hassan Mohammadipour Anvari dr.anvaritbzmed@yahoo.com 200319475328460088466 200319475328460088466 No Department of Anesthesiology and Operating Room, Tabriz University of Medical Sciences Tabriz, Iran Hossein Shiri Shiri_h@yahoo.com 200319475328460088467 200319475328460088467 No Tabriz University of Medical Sciences Tabriz, Iran Saeid Charsouei S_Charsouei@yahoo.com 200319475328460088468 200319475328460088468 No Department of Neurology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Nima Ashrafi V_Ashrafi@gmail.com 200319475328460088469 200319475328460088469 No Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Mansour Rezaei mansourrezaei@tbzmed.ac.ir 200319475328460088470 200319475328460088470 Yes Department of Anesthesiology and Operating Room, Tabriz University of Medical Sciences Tabriz, Iran