Comparing Oral Melatonin and Intraoperative Lidocaine Infusion to Prevent Delirium After Hip Replacement Surgery in Older Adults

What this Trial Is About

Researchers are evaluating the effects of oral melatonin compared to intraoperative lidocaine infusion on the occurrence of postoperative delirium in elderly patients undergoing total hip arthroplasty with spinal anesthesia. Postoperative delirium is a common condition in this population, characterized by sudden disturbances in attention and awareness, often fluctuating in severity and appearing within five days after surgery. The study aims to better understand how these treatments may influence delirium incidence and related outcomes in this high-risk group. Participants are assigned to one of three groups one receiving oral melatonin capsules at 9 pm the night before surgery, the night of surgery, and for two nights after surgery along with intravenous saline during surgery another receiving intravenous lidocaine starting with a bolus before anesthesia induction and continuous infusion during surgery, plus placebo capsules and a control group receiving saline infusions and placebo capsules at the same times. The treatments are administered before and during surgery, with monitoring continuing through the postoperative period. During the study, researchers will monitor participants for postoperative delirium incidence, severity, onset, and duration over the first five days after surgery. They will also assess pain levels 24 hours after surgery, hospital stay length, and any adverse effects within 24 hours postoperatively. Participants undergo assessments including mental testing before surgery and close observation after surgery to capture these outcomes. The total duration of participation includes the preoperative dosing and the postoperative monitoring period, extending up to hospital discharge.

Effect of Oral Melatonin Versus Intraoperative Lidocaine Infusion on Incidence of Postoperative Delirium in Elderly Patients Undergoing Total Hip Arthroplasty