Effect of Different Administration Routes of Dexmedetomidine on Postoperative Delirium in Elderly Patients Undergoing Elective Spinal Surgery: A Prospective Randomized Double-Blinded Controlled Trial
Authors' conclusion
For patients aged ≥60 years undergoing spinal surgery, compared with the intranasal route of dexmedetomidine, intravenous and intratracheal dexmedetomidine reduced the incidence of early POD.
Study context
- Population
- Patients aged 60 years or more scheduled for spinal surgery
- Participants
- 150 patients
- Comparison
- Intravenous vs intranasal vs intratracheal dexmedetomidine
- Primary endpoint
- Frequency of delirium (postoperative delirium (POD))
- Follow-up
- First 3 postoperative days
Methodological detailsprospective, double-blinded
- Prospective
- Double-blinded
Primary result
As reported in the abstract
Odds ratio (95% CI)P value
Intravenous vs Intranasal
0.17(0.05–0.63)
P < 0.017Intratracheal vs Intranasal
0.29(0.10–0.89)
P < 0.017Intratracheal vs Intravenous
1.74(0.40–7.73)
P > 0.017Secondary outcomes
Postoperative sore throat (POST) · 2 hours after surgery
Median
| Outcome | Intravenous | Intranasal | Intratracheal |
|---|---|---|---|
| Pittsburgh Sleep Quality Index score · second morning after surgery | 4 (IQR 3–5) | 6 (IQR 4–7) | 6 (IQR 4–7) |
- Postoperative sore throat (POST) — Lower in intratracheal than other 2 groups
- P < .017
- Pittsburgh Sleep Quality Index score — Lowest in intravenous
- P < .017
- Pittsburgh Sleep Quality Index score: group order of the 2nd and 3rd values not stated explicitly
Safety
Bradycardia and PONV
- Intravenous vs intranasal: higher bradycardia rate, lower PONV incidence
- P < 0.017
Hypertension
- Highest incidence in intranasal
- P < 0.017
Original publication
Effect of Different Administration Routes of Dexmedetomidine on Postoperative Delirium in Elderly Patients Undergoing Elective Spinal Surgery: A Prospective Randomized Double-Blinded Controlled Trial. Anesth Analg. Published 14 April 2023. doi:10.
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