Dexmedetomidine Supplemented Analgesia and Delirium After Hip Fracture Surgery
Elderly, Hip Fracture Surgery, Patient-controlled Analgesia
About this trial
This is an interventional prevention trial for Elderly focused on measuring Elderly, Hip fracture surgery, Patient-controlled analgesia, Dexmedetomidine, Postoperative delirium
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 65 years but < 90 years;
- Scheduled to undergo hip fracture surgery;
- Planned to use patient-controlled intravenous analgesia (PCIA) after surgery.
Exclusion Criteria:
- Refuse to participate in this study;
- Preoperative history of schizophrenia, epilepsy, Parkinsonism, or myasthenia gravis;
- Inability to communicate in the preoperative period because of coma, profound dementia or language barrier;
- Preoperative obstructive sleep apnea (diagnosed sleep apnea syndrome or a STOP-Bang score ≥3 combined with a serum bicarbonate ≥28 mmol/L);
- Sick sinus syndrome, severe sinus bradycardia (< 50 beats per minute), or second-degree or above atrioventricular block without pacemaker;
- Severe hepatic dysfunction (Child-Pugh class C);
- Severe renal dysfunction (requirement of renal replacement therapy before surgery);
- American Society of Anesthesiologists physical status >IV, or estimated survival ≤24 h.
Sites / Locations
- Peking University First HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Dexmedetomidine group
Control group
Patients in this group receive dexmedetomidine-supplemented patient-controlled analgesia for up to 3 days after surgery. The formula is a mixture of dexmedetomidine (1 microgram/ml) and sufentanil (1 microgram/ml), diluted with normal saline to 200 ml. The analgesic pump is programmed to administer a background infusion at a rate of 1 ml/h, with a bolus dose of 2 ml at each time and a lockout interval of 8 minutes.
Patients in this group receive routine patient-controlled analgesia for up to 3 days after surgery. The formula is a mixture of placebo and sufentanil (1 microgram/ml), diluted with normal saline to 200 ml. The analgesic pump is programmed to administer a background infusion at a rate of 1 ml/h, with a bolus dose of 2 ml at each time and a lockout interval of 8 minutes.