Postoperative delirium is commonly observed in elderly patients in the postanesthesia care
unit (PACU) and during the first 2-3 days following surgical procedures. This is an important
clinical problem in the geriatric surgical patient; morbidity and mortality rates are
significantly higher in patients who develop delirium. At the present time, the etiology of
delirium has not been precisely defined. However, studies suggest that inflammation related
to the surgical stress response is an important contributing factor in inducing
neuroinflammation and subsequent cognitive dysfunction and delirium. Therefore it is possible
that agents which attenuate perioperative inflammation may reduce the risk of the development
of delirium following surgery. Dexamethasone is a potent corticosteroid that is used by
anesthesiologists primarily as an antiemetic agent. Small doses of dexamethasone have also
been demonstrated to significantly reduce the release of inflammatory markers after surgery.
The anti-inflammatory effects of corticosteroids have the potential to beneficially impact
neuroinflammation and the risk of developing postoperative delirium. The aim of this
randomized, controlled, double-blinded investigation is to determine if dexamethasone,
administered at induction of anesthesia, can decrease the incidence of delirium at the time
of discharge from the PACU and during the first 2 days following surgery.
Phase:
Phase 4
Details
Lead Sponsor:
NorthShore University HealthSystem NorthShore University HealthSystem Research Institute