A prospective, randomized exploratory study: Association of preemptive analgesia combined with preoperative transnasal insulin therapy with reduced postoperative delirium in elderly patients undergoing lower extremity fracture surgery.
Gen Hosp PsychiatryJul 1, 2026 (epub)
Hong-Zhen Bai, Peng-Zhan Shuang, Yi-Na Wang et al.
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In 30 seconds
This prospective, randomized exploratory trial studied the effects of preoperative intranasal insulin combined with preemptive analgesia on postoperative delirium (POD) in 186 elderly patients undergoing lower extremity fracture surgery. The results indicated that the incidence of POD was significantly lower in the combination group (17.74%) compared to the control group (38.71%; corrected P = 0.009).
Key findings
- The incidence of postoperative delirium was 17.74% in the insulin and analgesia group versus 38.71% in the control group.
- Group IP showed significantly lower NRS pain scores at P2 and P4 compared to Group C (both nominal P < 0.001).
- Group IP had lower SRSS sleep scores at P3 compared to Group C (nominal P < 0.001).
- Postoperatively, Group IP exhibited lower glucose, insulin resistance, and p-tau levels compared to both Group C and Group I.
Why it matters
Postoperative delirium is a common and serious complication in elderly patients, impacting recovery and outcomes. Understanding interventions that can reduce its incidence is crucial for improving patient care in this vulnerable population.