Incidence Of Post-Operative Delirium In Geriatric Patients Undergoing Hip Replacement Surgery Using Pre-Operative Haloperidol

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Fahmy Saad Latif Eskander ◽  
Karim Youssef Kamal Hakim ◽  
Dalia Ahmed Ibrahim ◽  
Wael Safwat El-Mallah

Abstract Background Delirium is acute onset & fluctuating disturbance in mental state that causes patient appear confused, disoriented or with difficulty to focus and with decline in cognitive function (memory, orientation, speech), circadian disturbance and behavior of patient either agitated or sleepy,in other words sudden confusion. Delirium, also known as acute confusional state, is an organically-caused decline from a previously baseline level of mental function that develops over a short period of time (hours to days). Delirium is not a disease itself, but a syndrome encompassing disturbances in attention, consciousness, and cognition. It may also involve other neurological deficits, like psychomotor disturbances (e.g. hyperactive, hypoactive, or mixed), impaired sleepwake cycle, emotional disturbances, and perceptual disturbances (e.g. hallucinations and delusions). Objective To determine incidence of post-operative delirium in geriatric patients undergoing hip replacement surgery using pre-operative haloperidol. Patients and Methods This study is conducted through geriatric patients undergoing orthopedic surgery and the incidence of pre.& post-operative delirium. This randomized, double-blind, placebo-controlled trial was conducted post-operative surgical ICU in Demerdash hospital which was closed unit and had the same well-established pain, sedation and delirium assessment practices. A delirium was monitored through CAM score in their stay in ICU (max. for &7 days from admission post-operative). Results Several trials stated that the usage of Haloperidol pre-operative decrease the duration and the severity of Delirium rather than the incidence of delirium. In our trial we will detect the incidence of delirium with using prophylactic haloperidol in geriatric patients undergoing Hip replacement surgery. In our study revealed that using prophylactic pre-operative haloperidol decrease the incidence of delirium among geriatric patient as well as decreasing both the duration and the severity of delirium among the study group. Conclusion Our study and results revealed that Haloperidol as antipsychotic drug have beneficial effect on reduction of incidence of delirium in post-operative geriatric patients, also it showed effect on duration of delirium and severity of the disease as well as ICU stay.

2005 ◽  
Vol 101 (4) ◽  
pp. 1104-1111 ◽  
Author(s):  
G Lynn Rasmussen ◽  
Kerstin Malmstrom ◽  
Michael H. Bourne ◽  
Maurice Jove ◽  
Steven M. Rhondeau ◽  
...  

1997 ◽  
Vol 77 (01) ◽  
pp. 026-031 ◽  
Author(s):  
O E Dahl ◽  
G Andreassen ◽  
T Aspelin ◽  
C Müller ◽  
P Mathiesen ◽  
...  

SummaryDiscontinuation of thromboprophylaxis a few days after surgery may unmask delayed hypercoagulability and contribute to late formation of deep venous thrombosis (DVT). To investigate whether thromboprophylaxis should be prolonged beyond the hospital stay, a prospective, double-blind randomised study was conducted in 308 patients. All patients received initial thromboprophylaxis with dalteparin, dextran and graded elastic stockings. On day 7, patients were randomised to receive dalteparin (Fragmin®) 5000IU once daily, or placebo, for 4 weeks. All patients were subjected to bilateral venography, perfusion ventilation scintigraphy and chest X-ray on days 7 and 35. Patients with venographically verified proximal DVT on day 7 were withdrawn from the randomised study to receive anticoagulant treatment. The overall prevalence of DVT on day 7 was 15.9%. On day 35, the prevalence of DVT was 31.7% in placebo-treated patients compared with 19.3% in dalteparin-treated patients (p = 0.034). The incidence of DVT from day 7 to day 35 was 25.8% in the placebo-treated group versus 11.8% in the dalteparin-treated group (p = 0.017). The incidence of symptomatic pulmonary embolism (PE) from day 7 to day 35 was 2.8% in the placebo-treated group compared with zero in the dalteparin-treated group. This included one patient who died from PE. No patients experienced serious complications related to the injections of dalteparin or placebo. This study shows that prolonged thromboprophylaxis with dalteparin, 5000 IU, once daily for 35 days significantly reduces the frequency of DVT and should be recommended for 5 weeks after hip replacement surgery.


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