engleski

INTRATHECAL DEXAMETHASONE FOR PREVENTION OF COGNITIVE DYSFUNCTION 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 model was 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 ran- domized double- blind study. Patients were divided into two equal groups ; group DLSA received 8 mg dexamethasone, group LSA did not receive dexametha- sone, 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.

inrathecal dexamethasone ; spinal anaesthesia ; emergency ; cognitive dysfunction ; hip fracture

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