Evaluation of Dexmedetomidine on Delirium in Elderly Patients Postoperatively: A Randomized Controlled Trial

Delirium, a common acute brain dysfunction in older adults, features rapid changes in attention, awareness, and thinking that fluctuate. It presents diversely with altered activity levels and sleep. Postoperative delirium (POD), often seen in the postanesthesia care unit, is a temporary mental status change, with hypoactivity being common. Low arousal is not the same as altered brain function.

It is a double-blind randomized controlled trial enrolling 130 patients. The primary objective was to determine whether intraoperative dexmedetomidine administration reduced the incidence of POD in elderly patients. Group A received dexmedetomidine infusion at 0.5 μg/kg/h without a loading dose after induction, and Group B received the same volume of normal saline after induction. Patients were assessed for delirium twice a day until the 5 th postoperative day.

Delirium was present in 14 participants (10.8%) in Group A and 25 participants (19.2%) in Group B, totaling 39 participants (30%) across both the groups. The majority of participants (71.8%) experienced delirium resolution within 24 h, with a higher proportion in Group B compared to Group A.

Dexmedetomidine demonstrated a beneficial role in reducing the incidence and duration of delirium, stabilizing hemodynamic parameters, and shortening hospital stay compared to normal saline. Incorporating dexmedetomidine into standard sedation protocols, alongside nonpharmacological strategies, may improve patient outcomes and enhance recovery.