Effect of prophylactic perphenazine on delirium after extubation in severe acute pancreatitis

Abstract Background: Severe acute pancreatitis (SAP) is a life-threatening condition that can require invasive mechanical ventilation (IMV) to ensure adequate oxygenation and ventilation. However, IMV can cause delirium, which negatively impacts patient outcomes. Perphenazine, an antipsychotic drug that blocks dopamine receptors, can alleviate symptoms such as irritability and restlessness that caused by delirium. This retrospective study aimed to identify risk factors associated with delirium in SAP patients after extubation and withdrawal from IMV, and to determine whether prophylactic use of perphenazine could reduce the incidence of delirium. Methods: Patients with SAP aged 18-75 years who underwent IMV and were successfully extubated offline after treatment were included. The clinical data were compared between patients who received perphenazine prophylactically or not. Results: A total of 40 patients were enrolled, with a mean age of 42 years and a male to female ratio of 1.58:1. The incidence of delirium was 22.50%. Univariate analysis and binary logistic regression showed that prophylactic use of perphenazine reduced the incidence of delirium. Fentanyl use was a risk factor for delirium in the univariate analysis. Patients in the delirium group were hospitalized longer than those in the non-delirium group. Prophylactic use of perphenazine might be helpful to reduce in-hospital mortality. Conclusion:Perphenazine might have a potential effect on post-extubation delirium in SAP patients.