engleski

INTRATHECAL DEXAMETHASON FOR PREVENTION OF COGNITIVE DISFUNCTION OF SURGICALLY TREATED HIP FRACTURES

Background and Aims: Cognitive dysfunction is a common complication after surgically treated hip fracture in spinal anesthesia. We hypothesized that intrathecal applied dexamethasone could effectively attenuate post-spinal pain and cognitive dysfunction following surgically treated hip fracture. Methods: Sixty male and female patients, ASA II- III, 50-95 years old were included in this prospective and randomized double-blind study. Patients were divided into two equal groups ; group DLSA received 8 mg dexamethasone, group LSA did not receive dexamethasone, each in addition to intrathecal isobaric levobupivacaine 0.5%. Cognitive dysfunction incidence, intensity and recurrence and adverse events were recorded for 10 days after the start of spinal anesthesia. Results: Regression modelwas statistically significant and it explains 27%variance of dependent variable and it classifies correctly 79% of patients. The exception is the PPBK group without dexamethasone, LSA group, which in comparison to DLSA group, increases probability of cognitive dysfunction occurrence for 7, 67 times (95% CI: 1, 39-42, 36 ; P=0, 019). Sixty male and female patients, ASA II-III, 50-95 years old were included in this prospective and randomized double-blind study. Patients were divided into two equal groups ; group DLSA received 8 mg dexamethasone, group LSA did not receive dexamethasone, each in addition to intrathecal isobaric levobupivacaine 0.5%. Cognitive dysfunction incidence, intensity and recurrence and adverse events were recorded for 10 days after the start of spinal anesthesia. Conclusions: Intrathecal applied dexamethasone was effective in attenuation of cognitive dysfunction compared to placebo in patients scheduled for surgically treated hip fracture under spinal anesthesia with less adverse events.

intrathecal dexamethason, cognitive function, hip fracture

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