Study leader Frederick E. Sieber, MD, said in the release that propofol, a short-acting anesthetic commonly used to induce anesthesia and keep patients asleep, and similar anesthetics may have some lingering anesthesia effects, which was not commonly believed.
The double-blind, randomized study reviewed 114 patients undergoing hip fracture repair at Johns Hopkins Bayview Medical Center. Patients first received spinal block anesthesia and were then either lightly sedated with propofol or more deeply sedated with the same medication, according to the release. The prevalence of postoperative delirium was significantly lower in the group that was lightly sedated. Deeply sedated patients were unresponsive during surgery, while the lightly sedated patients were able to respond to questions. Researchers judged how deeply sedated the patient became by placing an EEG monitor on the patient’s forehead, according to the release.
Studies have estimated the presence of delirium in elderly patients after hip fracture surgery to be between 16 percent and 62 percent. The study found that postoperative delirium was significantly reduced in patients that received lighter sedation, leading them to conclude that one incidence of delirium could be prevented in every 4.7 patients treated with lighter sedation.
The exact mechanism that leads to postoperative delirium remains unclear. Although most patients recover within 48 hours, the condition could lead to a higher chance of patients moving into an assisted-living facility or even death within the first year after surgery, according to the release.
Dr. Sieber said in the release that it was unclear whether the results would be the same with different sedative drugs or with patients who have more serious cognitive impairment prior to surgery. The patients in this study were either cognitively intact or had mild to moderate cognitive problems before having hip surgery, according to the release.
Read the release on lighter sedation in elderly hip fracture patients.
