Delirium, Delirium, Anesthesia Emergence
Conditions
Keywords
Delirium, melatonin, patients, surgery, postoperative, benzodiazepines, orthopedic, preoperatively
Brief summary
Postoperative delirium is a complication that should not be underestimated. As it elaborates many complications that could be avoided when an accurate assessment of the risk factors and interventional measures are taken appropriately when needed.
Detailed description
Delirium is a variation in concentration capabilities that occurs acutely in association with a disturbed level of consciousness. Delirium is more common in orthopaedic surgery patients than in general surgery patients. As delirium ratios range from 44% to 55% in hip surgery patients, otherwise only 10%-14% of general surgery patients. Several studies were carried out and found that melatonin levels correlate with the development of delirium postoperatively. This study was conducted to determine the efficacy of administering melatonin preoperatively in patients undergoing orthopedic surgery to prevent postoperative delirium.
Interventions
DRUGMelatonin
The patients were assessed using the Memorial Delirium Assessment Scale (MDAS) after the operation at 30, 60, and 90 min. Melatonin was shown to reduce delirium from 41.6% to 16.6% at 60 minutes, and the significant reduction was at 90 minutes (0%) when compared to both groups. Thus, melatonin was found to be successful in decreasing postoperative delirium when administered preoperatively.
OTHERNo intervention
No intervention was used.
DRUGMidazolam
7.5 mg of Midazolam orally.
Sponsors
University of Baghdad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
It has been done on all the study's contributors and workers.
Intervention model description
Patients were divided into three groups at random, with 12 patients in each group, using a double-blinded method.
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1- Patients in good general health. 2. Baseline MDAS \<13. 3. No seizure disorder.
Exclusion criteria
1. Patients with a neurological disorder (e.g., dementia, stroke, epilepsy). 2. Patients with a history of acute or chronic confusion. 3. Patients taking centrally acting drugs (e.g., antidepressants, antiparkinsonian drugs, sedatives, monoamine oxidase inhibitors), or alcohol abusers. 4. Patients who have medical disorders predisposing to delirium (e.g. cachexia, thyroid dysfunction, renal failure).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The efficacy of oral Melatonin in preventing Postoperative Delirium after general anesthesia | 1 week | This interventional trial is done to determine the efficacy of preoperative melatonin administration in reducing postoperative delirium rates. |
Countries
Iraq
Outcome results
None listed