Perioperative medicine & outcomes
A Randomized Clinical Trial of Dexmedetomidine on Delirium, Cognitive Dysfunction, and Sleep After Non-Ambulatory Orthopedic Surgery With Regional Anesthesia
Authors' conclusion
Sedation with dexmedetomidine resulted in a statistically and clinically important reduction in the incidence of POD, ED, and early POCD, while it improved self-reported postoperative sleep quality and reduced chronic pain scores in patients undergoing major elective lower limb surgery under regional anesthesia.
Study context
- Population
- Older adults undergoing major lower limb orthopedic surgery under RAall completed follow-up
- Participants
- 80 adults
- Comparison
- Dexmedetomidine vs propofol for sedation
- Dexmedetomidinen = 41
Methodological detailsdouble-blind, 1:1 randomisation
- Double-blind
- 1:1 randomisation
Primary result
As reported in the abstract
Postoperative delirium (POD) incidence
P = 0.001
Secondary outcomes
Early POCD
P < 0.001
| Outcome | Dexmedetomidine | Propofol | P value |
|---|---|---|---|
| Emergence delirium (Riker Sedation-Agitation scale) | 2.4% | — not stated in the abstract | P < 0.001 |
| Sleep quality (PSQI score; lower = better) · immediate postoperative period | 4.4 ± 0.7 | 13.4 ± 0.8 | P < 0.001 |
| Chronic pain (painDETECT score) · 3 months | 2.4 ± 0.9 | 5.3 ± 0.9 | P = 0.023 |
— not stated in the abstract
Safety
- Airway obstruction in a single patient in the dexmedetomidine group
- 2.4% vs 30.8%, P = .002
- Intraoperative bradycardia and hemodynamic instability episodes more common in the dexmedetomidine group
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
A Randomized Clinical Trial of Dexmedetomidine on Delirium, Cognitive Dysfunction, and Sleep After Non-Ambulatory Orthopedic Surgery With Regional Anesthesia. Anesth Analg. Published 22 May 2025. doi:10.
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