Postoperative Recovery in Elderly Patients Undergoing Hip Hemi-arthroplasty
- Conditions
- Femoral Neck FracturesPostoperative ComplicationsInflammatory ResponsePostoperative DeliriumPostoperative Cognitive Dysfunction
- Interventions
- Procedure: hip arthroplastyDrug: Total Intravenous Anesthesia and Peripheral nerve blocks
- Registration Number
- NCT01934049
- Lead Sponsor
- Chinese PLA General Hospital
- Brief Summary
Hip fractures incidence grows rapidly with the aging of the population. After indicated surgical treatment, hip fracture patients experience high rates of postoperative complications, postoperative delirium (PD), postoperative cognitive dysfunction (POCD), leading to poor postoperative recovery during hospitalization, which can cause disability, distress for both patients and their families, are associated with other medical complications and account for significant additional health care costs. We currently use dexmedetomidine in elderly patients with hip fractures undergoing hip hemi-arthroplasty in order to improve postoperative recovery and prevent and treating PD and POCD.
Dexmedetomidine is a drug used for sedation in critically ill patients that provides some pain relief and controls the bodies response to stress. The sedation produced by dexmedetomidine appears more similar to natural sleep than any other drug used for anesthesia and postoperative sedation. Data suggesting that dexmedetomidine can prevent delirium following cardiac surgery and the developing understanding of the causes of PD and POCD suggest that dexmedetomidine will be particularly effective.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 80
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Dexmedetomidine hip arthroplasty Dexmedetomidine in dex group is administered as 1ug/kg by intravenous infusion 10 min and then 0.6 ug/kg until 30 minutes before the operation finishes. Dexmedetomidine Total Intravenous Anesthesia and Peripheral nerve blocks Dexmedetomidine in dex group is administered as 1ug/kg by intravenous infusion 10 min and then 0.6 ug/kg until 30 minutes before the operation finishes. Saline hip arthroplasty Participants in con group receive placebo(saline) as the same dose at the same time as dex group. Saline Total Intravenous Anesthesia and Peripheral nerve blocks Participants in con group receive placebo(saline) as the same dose at the same time as dex group.
- Primary Outcome Measures
Name Time Method postoperative cognitive dysfunction(POCD) 7days POCD is assessed by Montreal Cognitive Assessment(MoCA), which was designed as a rapid screening instrument for mild cognitive dysfunction. It assesses different cognitive domains: attention and concentration,executive functions, memory, language,visuoconstructional skills, conceptual thinking,calculations, and orientation. Time to administer the MoCA is approximately 10 minutes. The total possible score is 30 points; a score of 26 or above is considered normal.
- Secondary Outcome Measures
Name Time Method Postoperative recovery 7days The postoperative recovery is assessed by the Post-operative Quality Recovery Scale (PQRS),which is a research tool designed to measure postoperative quality of recovery in multiple domains and over multiple time periods. Recovery domains include physiological, emotive (depression and anxiety), nociceptive (pain and nausea), cognitive, activities of daily living (ADL), and overall patient perspective (including satisfaction).
Postoperative Delirium(PD) 72 hours The postoperative Delirium is assessed by the Confusion Assessment Method (CAM)
Trial Locations
- Locations (1)
Anesthesia and Operation Center, Chinese People's Liberation Army General Hospital
🇨🇳Beijing, China