scholarly journals Effect of a single pre‐operative 125 mg dose of methylprednisolone on postoperative delirium in hip fracture patients; a randomised, double‐blind, placebo‐controlled trial

Anaesthesia ◽  
2018 ◽  
Vol 73 (11) ◽  
pp. 1353-1360 ◽  
Author(s):  
C. G. Clemmesen ◽  
T. H. Lunn ◽  
M. T. Kristensen ◽  
H. Palm ◽  
N. B. Foss
Keyword(s):  
Hip Fracture ◽  
Postoperative Delirium ◽  
Controlled Trial ◽  
Double Blind ◽  
Double Blind Placebo

scholarly journals Effects of dexmedetomidine on postoperative delirium and expression of IL-1, IL-6, and TNF-α in elderly patients after hip fracture operation

2020 ◽  
Author(s):  
Wenchao Zhang ◽  
Tianlong Wang ◽  
Geng Wang ◽  
Minghui Yang ◽  
Yan Zhou ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Early Stage ◽  
Surgical Complication ◽  
Controlled Trial ◽  
Venous Blood ◽  
Inflammatory Factors ◽  
Double Blind ◽  
Tnf Α

Abstract Background: Postoperative delirium (POD) is a common surgical complication in elderly patients. This study investigated the effects of dexmedetomidine on POD and inflammatory factors in elderly patients with hip fracture.Methods: The randomized, double-blind, controlled trial enrolled patients aged ≥65 years who underwent operation for hip fracture in the Department of Anesthesiology in Beijing JiShuiTan Hospital from October 2016 to January 2017. The patients were divided into the DEX group and the NS group and were intravenously infused with dexmedetomidine or an equal volume of normal saline, respectively. After surgery, the incidence of delirium at postoperative day 1 (T1), day 2 (T2) and day 3 (T3) were assessed using the Ramsay score and Confusion Assessment Method (CAM) delirium scale. Interleukin (IL)-1, IL-6 and tumor necrosis factor (TNF)-α concentrations in the venous blood of the two groups of patients were detected at T0 (before surgery), T1 and T3.Results: Data from 218 patients were analyzed with 110 patients in the DEX group and 108 in the NS group. Dexmedetomidine decreased POD incidence (18.2% vs. 30.6%, P=0.033). Compared to T0, all three inflammatory factors increased at T1 and then decreased at T3 and changes with time were significant (all P<0.001). IL-6 (P<0.001) and TNF-α (P=0.003) levels were lower in the DEX group, but IL-1 levels were similar. The rate of adverse events was similar in the two groups.Conclusions: Dexmedetomidine reduced the incidence of POD in elderly patients with hip fracture at an early stage, and reduced short-term IL-6 and TNF-α concentrations.

A Randomised, Double-Blind, Placebo-Controlled Trial of Dermatan Sulphate for Prevention of Deep Vein Thrombosis in Hip Fracture

1992 ◽  
Vol 67 (02) ◽  
pp. 203-208 ◽  
Author(s):  
Giancarlo Agnelli ◽  
Benilde Cosmi ◽  
Paolo Di Filippo ◽  
Valeria Ranucci ◽  
Franca Veschi ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Hip Fracture ◽  
Controlled Trial ◽  
Second Phase ◽  
Dermatan Sulphate ◽  
Heparin Cofactor Ii ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryDermatan sulphate (MF 701) is a natural glycosaminoglycan that catalyses thrombin inhibition by heparin cofactor II. The aim of the study was to evaluate the efficacy and safety of MF 701 for prevention of deep vein thrombosis (DVT) in patients with hip fracture. A randomised, double-blind, placebo-controlled design was used to assess two dose regimens of MF 701 in two consecutive study phases. Treatment was started within 48 h from the trauma and continued for 14 days for non-operated patients or until the 10th postoperative day. Bilateral mandatory venography was used to assess the end-point. Eighty patients were included in the first phase (40 MF 701, 40 placebo). MF 701, 100 mg IM b. i. d., did not reduce incidence of DVT from that on placebo and did not induce any bleeding. In the second phase 126 patients were included, with a randomisation ratio of 2:1 (84 MF 701, 300 mg IM b.i.d., 42 placebo). Bilateral venography was obtained for 110 patients. The incidence of DVT was 64% (23/36) in the placebo group and 38% (28/74) in the MF 701 group (p = 0.01; odds ratio [OR] = 0.34, 95% confidence limits [CL] = 0.15-0.80); proximal DVTs were 42% (15/36) and 20% (15/74), respectively (p = 0.02; OR = 0.36, CL = 0.15-0.89). No significant differences were found in haemorrhagic complications (2.4% in each group), blood loss from drains, blood transfusions, haemoglobin and haematocrit values. This study is the first demonstration that dermatan sulphate is a clinically effective antithrombotic agent without bleeding effects. It also provides evidence of the biological role of heparin cofactor II.

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