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| Effect of Dexamethasone on postoperative delirium and cognitive dysfunction in elderly patients with joint replacement surgery |
| LYU Xuewen HUANG Wen DONG Shuhua▲ |
| Department of Anesthesiology, the First Affiliated Hospital of Chengdu Medical College, Sichuan Province, Chengdu 610500, China |
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Abstract Objective To study the effect of Dexamethasone on postoperative delirium and cognitive dysfunction in elderly patients with joint replacement surgery. Methods Two hundred and twenty-five elderly patients with joint replacement surgery [≥65 years old, American Society of Anesthesiologists (ASA) Ⅱ-Ⅲ grade] in the First Affiliated Hospital of Chengdu Medical College from September 2015 to December 2016 were selected. These patients were divided into low dose of Dexamethasone group (group D1), high dose of Dexamethasone group (group D2) and control group (group C) by random number table, with 75 cases in each group. One hour before operation, group D1 was given intravenous injection of Dexamethasone 10 mg, group D2 was given intravenous injection of Dexamethasone 20 mg, group C was given intravenous injection of equal quantity of normal saline. The confusion assessment method-Chinese revision (CAM-CR), mini-mental state examination (MMSE) and visual analogue scale (VAS) were used to evaluate postoperative delirium, postoperative cognitive dysfunction and postoperative pain of the patients respectively. Results After operation for 1, 3, 7 days, the scores of CAM-CR in group D1 and D2 were all lower than those of group C, and the scores of MMSE were all higher than those of group C, with statistically significant differences (all P ＜ 0.01), while there were no significant differences of VAS scores compared with those of group C (P ＞ 0.05). There were no significant differences of the scores of CAM-CR, MMSE and VAS after operation for 1, 3, 7 days between group D1 and D2 (all P ＞ 0.05). After operation for 1, 3, 7 days, the incidence of postoperative delirium and cognitive dysfunction were all lower than those of group C, with statistically significant differences (all P ＜ 0.05), while there were no significant differences of the incidence of postoperative delirium and cognitive dysfunction after operation for 1, 3, 7 days between group D1 and D2 (P ＞ 0.05). Conclusion Application of Dexamethasone before operation can reduce the incidence of postoperative delirium and postoperative cognitive dysfunction in elderly patients underwent joint replacement surgery.
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