Dexmedetomidine potential in attenuating postoperative delirium in elderly patients after total hip joint replacement

OBJECTIVE: This study aims to evaluate the effectiveness of dexmedetomidine in reducing the occurrence of postoperative delirium in elderly patients after total hip joint replacement. METHODS: Patients who have undergone total hip joint replacement and who were admitted to the hospital from August 1, 2017, to August 1, 2020, were included in this study. After initial screening, 327 out of 385 patients were selected and randomly assigned to either dexmedetomidine (0.1 μg/kg/h, n=163) or placebo (n=164) groups. The occurrence of delirium was examined twice a day for one week by using the Confusion Assessment Method. Furthermore, 30-day all-cause mortality, hospitalization duration and costs, and the presence of any postoperative complications were also evaluated. RESULTS: The postoperative delirium incidence was significantly lower in the dexmedetomidine group compared to that in the placebo group (13.8 vs. 29.3%, p<0.01). The hospitalization duration (17.2±6.3 vs. 15.6±4.2, p=0.006) and cost (4.5±0.9 vs. 4.9±1.1, p=0.001) in the dexmedetomidine group were also lower than those in the placebo group. Meanwhile, no significant difference between the 30-day all-cause mortality of the two groups was observed (p=0.60). In terms of safety, no significant differences between the occurrence of hypotension and bradycardia were also observed. CONCLUSION: Our findings show that the dexmedetomidine medication can reduce the postoperative delirium incidence in older total hip joint replacement patients and can subsequently decrease the related hospitalization duration and cost of these patients.