AI Article Synopsis
- Postoperative delirium (POD) is a frequent issue in surgeries, especially in older patients undergoing neurological procedures, with a notable incidence of 19%. Research indicates that dexmedetomidine (DEX) may lower the risk of POD after non-cardiac surgeries in elderly patients, but its effects on POD in neurosurgery are not well-explored.
- This study is a randomized, double-blind trial involving patients over 65 years scheduled for elective craniotomy, comparing DEX infusion against a control group receiving saline to assess the incidence of POD within the first five postoperative days using several evaluation methods.
- Ethical approval has been secured, and the results will be published in a peer
Article Abstract
Introduction: Postoperative delirium (POD) is a common surgical complication. The incidence is 19% in neurological procedures, and advanced age is a risk factor for neurological procedures. Many studies have shown that dexmedetomidine (DEX) reduced the incidence of delirium after non-cardiac surgery in elderly patients. However, there are few studies focus on the effect of DEX on POD in elderly patients undergoing neurosurgery.
Methods And Analysis: This is a randomised, double-blinded, paralleled-group and controlled trial. Patients older than 65 years and scheduled for elective craniotomy will be randomly assigned to the DEX group and the control group. After endotracheal intubation, patients in the DEX group will be administered with continuous DEX infusion at rate of 0.4 µg/kg/hour until the surgical haemostasis. In the control group, patients will receive the identical volume of normal saline in the same setting. The primary outcome is the incidence of POD during the first 5 days. Delirium will be evaluated through a combination of three methods, including the Richmond Agitation Sedation Scale (RASS), the confusion assessment method for ICU (CAM-ICU) and the 3 min diagnostic interview for CAM (3D-CAM). The RASS, CAM-ICU and 3D-CAM will be evaluated two times per day (08:00-10:00 and 18:00-20:00 hours) during the first postoperative 5 days. Secondary outcomes include pain severity score, quality of recovery, quality of sleep, cognitive function, psychological health state, intraoperative data, physiological status, length of stay in ICU and hospital, hospitalisation costs, non-delirium complications, and 30-day all-cause mortality.
Ethics And Dissemination: The protocol (V.4.0) has been approved by the medical ethics committee of Beijing Tiantan Hospital, Capital Medical University (KY2021-194-03). The findings of the study will be disseminated in a peer-reviewed journal and at a scientific conference.
Trial Registration Number: NCT05168280.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9872465 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2022-063976 | DOI Listing |
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