Anästhesie und klinische Forschung
Offener Zugang

Abstrakt

Postoperative Delirium in Elderly Patients Undergoing Elective Orthopedic Surgeries: A Comparative Study between Dexmedetomidine and Haloperidol

Elsayed M Abdelzaam, Ahmed M Abdelhamid and Hany Talaat Abdelgelil

Background and aim: Delirium in surgical patients has a profound impact on postoperative outcomes. The main target of this study to compares the effect of Dexmedetomidine versus haloperidol in the incidence and severity of postoperative delirium in elderly patients undergoing elective orthopedic surgery under general anesthesia.

Patients and methods: Sixty elderly patients scheduled for orthopedic surgery under general anesthesia were randomly allocated into three groups. In the control group, patients received normal saline. In the dexmedetomidine group, patients received dexmedetomidine 1 μg/kg over 20 minutes then continuous infusion at a rate of 0.5 μg/kg/h until the end of surgery. In the haloperidol group, patients received haloperidol 2.5 mg IV over 20 minutes, followed by continuous infusion of 1 mg/h until the end of surgery. The primary outcome of the number of patients developed delirium and the degree of severity of postoperative delirium. The secondary results were the duration of surgery, hemodynamic variables, and Visual analogue scale (VAS).

Results: Hemodynamic variables (MAP and HR) were significantly lower in the dexmedetomidine group when compared to haloperidol and control groups. In the dexmedetomidine group, VAS was considerably lower immediately postoperative and up to 4 hours. The incidence and the severity of postoperative delirium were significantly reduced in the dexmedetomidine group.

Conclusion: The prevalence and severity of postoperative delirium were decreased significantly with the intraoperative administration of dexmedetomidine infusion when compared with haloperidol.