Status:

UNKNOWN

How Different Sedatives Affect Hip Fracture Patient's Postoperative Delirium

Lead Sponsor:

Shanghai Zhongshan Hospital

Collaborating Sponsors:

First Affiliated Hospital of Guangxi Medical University

The Second Affiliated Hospital of Harbin Medical University

Conditions:

Delirium in Old Age

Eligibility:

All Genders

65-90 years

Phase:

PHASE4

Brief Summary

the hypothesis is that Dexmedetomidine seems to decrease incidence of post-operative delirium . one possible mechanism is that Dex have a minor influence on cognition, since it has no effect on GABA r...

Detailed Description

With a complex etiology, delirium is usually caused by various peri-operative stimuli on basis of predisposing factors, including senility, hypoxia and hypotension, pain, drug (such as pethidine, benz...

Eligibility Criteria

Inclusion

  • Acquisition of informed consent,
  • Patients with hip fracture surgery under lumbar anesthesia,
  • Grade II to III based on American Society of Anesthesiologists ASA classification,
  • Age ≥65 and ≤90 years old.

Exclusion

  • History of psychiatric disease or a disease needing long-term exposure to psychotropic drugs (dementia, schizophrenia), or history of alcoholic abuse.
  • More than 8 errors in preoperative Simplified Psychology and Mental Status Questionnaire (SPMSQ) , and diagnosed as severe cognitive impairment.
  • CAM positive diagnosed preoperatively.
  • Any cerebrovascular accident occurring within 3 months, such as cerebral stroke or transient ischemic attack (TIA).
  • Systolic pressure \< 90mmHg and diastolic pressure \< 60mm Hg at the preoperative follow up or HR\< 50/minute.
  • History of heat failure or EF\<30% as shown by ultrasound cardiogram; degree 2 type 2 and degree 3 atrioventricular block. History of active heart disease (such as acute cardiac infarction, unstable angina pectoris)
  • Severe abnormality in hepatic or renal function (severe abnormality in liver function: more than 2-times increase than upper normal limit in any one of the markers including ALT,, conjugated bilirubin, AST, ALP, total bilirubin; severe abnormality in renal function; Cr clearance\<30ml/min), Scr\>443μmol/L.
  • Diabetes patients with severe complications of diabetes (Diabetic ketoacidosis, hyperosmolar coma, various infections, macrovascular diseases, and diabetic nephropathy)
  • Patients with severe infection.
  • Postoperative PaO2\<60mmHg or SpO2\<92%.
  • Participation in clinical trials of other drugs within past 30 days.
  • Disturbed verbal communication, and unable to accomplish the test on cognition.
  • Patients with prosthesis fracture or restoration; hip fracture but complicated with severe trauma in other sites.
  • Being allergic to investigational drug or having contradiction of lumbar anesthesia.

Key Trial Info

Start Date :

January 1 2018

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

June 30 2019

Estimated Enrollment :

1000 Patients enrolled

Trial Details

Trial ID

NCT03346226

Start Date

January 1 2018

End Date

June 30 2019

Last Update

December 13 2017

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