engleski

The effect of dexamethasone added to spinal anesthesia on postoperative cognitive dysfunction and hospital length of stay

The aim of this research is to establish the effect of intrathecal dexamethasone administration in spinal anesthesia with levobupivacaine on postoperative cognitive dysfunction and the hospital length of stay for trauma patients with femur fracture. A total of 60 patients ASA2 and ASA3 status, scheduled for surgical procedures were sorted into two groups and underwent surgery. One group had spinal anesthesia with levobupivacaine, SA group, and the other study group had spinal anesthesiawith addition of dexamethasone, DSA group. The primary outcome measure was the occurrence of postoperative cognitive dysfunction (POCD). Length of hospitalization were secondary outcome measures. Postoperative cognitive dysfunction was a state of mental confusion in ten days after surgery. Length of hospitalization was the duration of hospital stay. Postoperative cognitive dysfunction was defined by using Confusion Assessment Method (CAM) criteria. Average age of DSA group was 81.63 (SD 6, 94) years and average age of SA group was 79, 67 (SD 10, 17) years (P=0, 370). CAM criteria showed that, 7 DSAvs 17 SA patients (23% vs 56, 7%) experienced postoperative cognitive dysfunction. Mean hospital length of stay of DSA group was 15, 90 (SD 6, 00) vs. SA was 17, 40 (SD 4, 00) days (P=0.045). There was apparent difference in POCD in DSAvs. SA group (P = 0.046). Our analysis confirmed that POCD was common but more than in SA vs. DSA patients and has influence on hospital length of stay. We concluded that spinal anesthesia with dexamethasone in comparison to the spinal anesthesia alone can facilitate rehabilitation and can reduce hospital stay.

dexamethasone ; spinal anesthesia ; cognitive dysfunction ; hospital length of stay

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