الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The POD is a form of delirium that manifests in patients who have undergone surgical procedures and anesthesia, usually peaking between one and three days after their operation. The incidence of POD is 2-3% in general surgical population and 50-70% in high-risk patients‘ group. POD is a serious postoperative complication, often leading to poor outcomes including increased mortality, increased length of hospital stay, functional disability, placement in long term care institutions and increased hospitalization costs. Dexmedetomidine is a selective alpha 2 agonist drug with sedative analgesic hypotensive anxiolytic effects blunting the sympathetic response to surgery and to other stress; additionally, it has an opioidsparing effect and does not significantly depress respiratory drive. It may be neuroprotective, and its use has been linked to decreased stress, inflammatory response, and increased postoperative cognitive function. The aim of this study was to assess the effects of intraoperative dexmedetomidine administration on incidence of POD in elderly patients undergoing total hip arthroplasty. This prospective randomized controlled double- blinded study was carried out on 70 patients aged ≥65 years with BMI (18.5-29.9)kg/m 2 , ASA physical status I-III, scheduled to undergo unilateral total hip arthroplasty. All patients were divided into two equal groups (35 patients each). Dexmedetomidine group (group D): Patients received intraoperative dexmedetomidine (Medrelaxmidine, ARABCOMED, Egypt, (200μg/50ml) infusion in a dose of 0.3μg/kg/hour. Control group (group C): Patients received equivalent volume of saline infusion. Summary of Our Results: • There was no statistically significant difference between dexmedetomidine group and control group regarding demographic data including age, sex, BMI and ASA physical status and duration of surgery. • There was no statistically significant difference between the studied groups regarding intraoperative blood loss. • Number of patients developed +ve CAM test was significantly higher in control group than dexmedetomidine group at 12hrs postoperatively, day 1 (morning and evening) and evening of day 2 postoperatively. • The incidence of POD was significantly higher in control group than dexmedetomidine group. • Number of patients developed hypoactive delirium was significantly lower in dexmedetomidine group than control group. • The duration of delirium was insignificantly different between the two studied groups. • Postoperative RAAS on PACU admission, at 12h, day1 evening, day2(morning and evening) and day 3 evening were significantly lower in dexmedetomidine group than control group. • The median (IQR) postoperative VAS scores in dexmedetomidine group were significantly lower as compared to control group on admission to PACU, at 6h,12h and 24h postoperatively. • The median (IQR) time to first postoperative morphine administration was significantly longer in dexmedetomidine group than control group. • The median (IQR) total dose of postoperative morphine consumption was significantly higher in control group than in dexmedetomidine group. • The mean values (± SD) of postoperative HR in dexmedetomidine group were significantly lower than control group on admission to PACU,at 6h,12h and 24h postoperatively. • The mean values (± SD) of postoperative MAP in dexmedetomidine group were significantly lower than control group on admission to PACU, at 6h and 12h postoperatively. • The mean values (± SD) of postoperative O2 saturation were insignificantly different between both groups on admission to PACU, at 6h, 12h and 24h postoperatively. • The length of hospital stay was insignificantly different between both groups. • The incidence of hypotension and bradycardia was insignificantly different between both groups.