Effect of low-dose dexmedetomidine on postoperative inflammatory response and delirium in elderly patients with hip fractures

Abstract

Objective  To evaluate the effect of prophylactic administration of low-dose dexmedetomidine (DEX) on inflammatory response in elderly patients after hip fracture surgery. Methods  Elderly patients with hip fractures who admitted to the intensive care unit (ICU) after surgery were randomly divided to two groups, labeled “DEX group” or “control group” DEX. DEX group were received a continuous infusion of 0.1 μ g·kg^-1·h^-1 DEX. Control group received 0.025 mL·kg^-1·h^-1 of 0.9% saline intravenously. The serum levels of procalcitonin and interleukin-6 in patients at 0 hours (immediate), 6 hours, 12 hours, and 18 hours after administration were detected. The hemodynamic parameters (heart index, stroke volume index, mean arterial pressure, heart rate) and the occurrence of delirium were recorded. Results  There was no statistically significant difference in the levels of procalcitonin and interleukin-6 between the two groups at each time points (P>0.05).The incidence of delirium in the DEX group was significantly lower than that in the control group (P=0.034). The number of cases of additional use of opioid in the DEX group (P=0.039) and hypertension (P=0.012) were significantly lower than those in the control group. Conclusion  Low dose DEX did not significantly reduce postoperative inflammatory indicators in elderly patients with hip fractures, but it helped to reduce the occurrence of delirium and use of opioid analyesics in patients. Low dose DEX has minimal impact on hemodynamics and may have a circulatory protective effect on patients with postoperative hypertension.

Keywords

dexmedetomidine / hip fracture in the elderly / delirium / hemodynamic / inflammatory response