Effects of Intranasal Dexmedetomidine on the Night Before Surgery on Postoperative Delirium in Elderly Patients Undergoing Total Knee/Hip Arthroplasty. A Parallel-Arm, Randomized Controlled, Non-Inferiority Trial.
Drug Des Devel TherSep 13, 2026 (epub)
Yangyang Chen, Keqin Wang, Yuqi Zhang et al.
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In 30 seconds
This randomized controlled trial evaluated the effects of preoperative intranasal dexmedetomidine on postoperative delirium in 316 elderly patients undergoing total knee or hip arthroplasty. The incidence of delirium was 9.5% in the intranasal group compared to 7.6% in the intravenous group, meeting the non-inferiority criterion (P < 0.001).
Key findings
- Postoperative delirium occurred in 9.5% of the intranasal group versus 7.6% in the intravenous group.
- The rate difference in delirium incidence was 0.02 (95% CI: -0.04 to 0.08).
- Patients receiving intranasal dexmedetomidine reported improved sleep quality and lower anxiety and pain scores.
- Adverse events were significantly lower in the intranasal dexmedetomidine group.
Why it matters
Identifying effective preoperative interventions to reduce postoperative delirium is essential, particularly in elderly patients who are at higher risk. This study suggests that intranasal dexmedetomidine may be a viable alternative to intravenous administration.