Postoperative Cognitive Dysfunction Postoperative Delirium Cognitive Impairment Elderly Surgical Patients Dexmedetomidine Postoperative Cognitive Dysfunction POCD Postoperative Delirium Cognitive Function Montreal Cognitive Assessment MMSE Spinal Anesthesia Hip Surgery Knee Surgery Elderly Patients Orthopedic Surgery Sedation Perioperative Care
Conditions
Interventions
Participants receive intravenous dexmedetomidine at a dose of 0.3 to 0.5 mcg/kg administered over 10 minutes during surgery under spinal anesthesia. Standard perioperative care is provided according t
Experimental Drug,No Intervention No treatment
Single-dose Dexmedetomidine,No Sedation Control
Sponsors
None listed
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Patients aged 60 years or older. 2. Scheduled for hip or knee surgery under spinal anesthesia. 3. American Society of Anesthesiologists (ASA) physical status 2-3
Exclusion criteria
Exclusion criteria: 1. Known allergy or hypersensitivity to dexmedetomidine. 2. Contraindication to spinal anesthesia. 3. Previous exposure to general anesthesia or regional anesthesia within the preceding 12 months. 4. Conversion from spinal anesthesia to general anesthesia during surgery. 5. History of neurological disorders including stroke, epilepsy, Parkinson disease, delirium, or dementia. 6. Severe hepatic dysfunction classified as Child-Pugh class C. 7. End-stage renal disease requiring renal replacement therapy.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Postoperative Cognitive Dysfunction 72 hours, 2 weeks and 3 months after surgery Incidence of postoperative cognitive dysfunction assessed using Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) | — |
Secondary
| Measure | Time frame |
|---|---|
| MoCA Score 72 hours, 2 weeks and 3 months after surgery Montreal Cognitive Assessment,MMSE Score 72 hours, 2 weeks and 3 months after surgery Mini-Mental State Examination,Postoperative Delirium 24 hours and 72 hours after surgery Thai version of the Confusion Assessment Method,Intraoperative Complications During surgery Occurrence of hypotension, bradycardia, and hypoxemia | — |
Countries
Thailand
Contacts
Public ContactChonlawan Chumjang
samutsakhon hospital
Outcome results
None listed