Dexmedetomidine vs Propofol Sedation Reduces Postoperative Delirium in Patients Receiving Hip Arthroplasty.

Study Overview
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Brief Summary
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With blocks of lumbar and lumbar plexus, we can reduce the intravenous anesthetics usage. To offer an satisfied surgery process for patients, a proper sedation is necessary. So in this study, we want to investigate the influence of two different sedative drugs on outcomes of patients received hip replacement surgery .

Official Title
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Dexmedetomidine vs Propofol Sedation Reduces Postoperative Delirium in Patients Receiving Hip Arthroplasty.

Conditions
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Anesthesia, Local Anesthesia

Intervention / Treatment
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* Drug: propofol
* Drug: dexmedetomidine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 65 years or older and undergoing hip fracture repair Exclusion Criteria: Patients with severe cognitive impairment (MMSE score, <15) Preoperative delirium as determined by Confusion Assessment Method Contraindications to local anesthesia Prior hip surgery Mental or language barriers that would preclude data collection Severe congestive heart failure (NewYork Heart Association class IV) Severe chronic obstructive pulmonary disease (Global Initiative for Chronic Obstructive Lung Disease guidelines, stage III-IV)

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: dexmedetomidine sedation<br>Patients received local anesthesia, in this arm, the sedation of patients was achieved with a bolus of dexmedetomidine at 1.0 μg/kg (over a period of 15 to 20 min) and followed by an infusion of dexmedetomidine at 0.2-0.7 μg/kg/h. | Drug: dexmedetomidine<br>* For patients in Group D, the sedation was achieved with a bolus of dexmedetomidine at 1.0 μg/kg (over a period of 15 to 20 min) and followed by an infusion of dexmedetomidine at 0.2-0.7 μg/kg/h. The depth of sedation was considered enough when patient was unresponsive to voice.<br>|
| Experimental: propofol sedation<br>Patients received local anesthesia, in this arm, the sedation of patients was achieved with a target-controlled infusion (TCI) of propofol, and the effect site concentration was set to 0.8-1.0μg/ml. | Drug: propofol<br>* For patients in Group P, the sedation was achieved with a target-controlled infusion (TCI) of propofol, and the effect site concentration was set to 0.8-1.0μg/ml.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of postoperative delirium |  | 7 days after surgery | 
| Mortality in 30 days after surgery |  | 30 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complications of cardiopulmonary system |  | 30 days after surgery | 
| Incidence of cerebrovascular accident |  | 30 days after surgery | 
| Out of bed time |  | 7 days after surgery | 
| Discharge time |  | 30 days after surgery | 
| Dosage of vasoactive agent |  | During sugary | 
| Extubation time |  | 7 days after surgery | 
| Hemodynamic index |  | intraoperative |