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Updated: Oct 10, 2025
08:17
A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration
Published on: February 27, 2018
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5-HT3 receptor antagonists decrease the prevalence of postoperative delirium in older patients undergoing orthopedic
Hyun-Jung Shin1, Jiwon Yoon1, Hyo-Seok Na2
1Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang, Seongnam, 13620, South Korea.
Perioperative Medicine (London, England)
|December 8, 2021
Summary
5-hydroxytryptamine 3 (5-HT3) receptor antagonists, like palonosetron, significantly reduced the risk of postoperative delirium (POD) in older adults undergoing orthopedic surgery. Palonosetron demonstrated superior efficacy in preventing POD.
Area of Science:
- Anesthesiology
- Geriatric Medicine
- Pharmacology
Background:
- Postoperative delirium (POD) is a common complication in elderly patients.
- 5-hydroxytryptamine 3 (5-HT3) receptor antagonists are being investigated for their potential to prevent or treat POD.
Purpose of the Study:
- To investigate the association between 5-HT3 receptor antagonists and the occurrence of POD in elderly patients undergoing orthopedic lower limb surgery.
- To compare the efficacy of palonosetron and ramosetron in preventing POD.
Main Methods:
- Retrospective review of electronic medical records for patients aged ≥ 65 years undergoing orthopedic lower limb surgery.
- Patients received either palonosetron or ramosetron intravenously prior to surgery.
- Multivariable logistic regression analysis was used to evaluate the association between 5-HT3 receptor antagonists and POD incidence.
Main Results:
- Of 855 patients, 710 received 5-HT3 receptor antagonists, with 46 (5.4%) developing POD.
- 5-HT3 receptor antagonists reduced POD incidence by 63% (OR 0.37, P = 0.04).
- Palonosetron administration decreased POD incidence by 72% (OR 0.28, P = 0.01).
- Risk factors for POD included emergency surgery, older age, hip surgery, low BMI, and intraoperative propofol sedation.
Conclusions:
- 5-HT3 receptor antagonists are associated with a significantly reduced risk of POD in elderly patients undergoing orthopedic lower limb surgery.
- Palonosetron appears to be more effective than ramosetron for POD prevention in this patient population.
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