engleski

Reducing delirium in elderly patients with femur fracture by adding dexamethasone to the local anesthetic in spinal anesthesia

Mortality after hip fracture has remained relatively unchanged for the last two decades. Currently, 8.4% of patients die within 30 days of surgery. However, it has been suggested that up to half of postoperative deaths are potentially preventable. Thirty-day mortality is increased for older, sicker, male patients. Up to 15–30% of patients die within a year of surgery. There is sufficient data that the effective pain mana- gement may reduce postoperative cognitive disturbances. The addition of dexamethasone to the local anesthetic administered intrathecally significantly prolongs the dura- tion of sensory block and decreases opioid requirements in postoperative management. Therefore, effective analgesia and the impact on the hypothalamic- pituitary-adrenal axis may reduce post- operative delirium in patients with femur fracture.

neuroendocrine response ; elderly trauma patients ; postoperative cognitive dysfunction

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