Effect of Intranasal Dexmedetomidine on the Night Before Surgery for Postoperative Delirium in Older…

Randomized trialDrug design, development and therapy· 2026

Effect of Intranasal Dexmedetomidine on the Night Before Surgery for Postoperative Delirium in Older Patients Undergoing Total Hip or Knee Arthroplasty: A Randomized Clinical Trial.

Yucheng Liu, Keqin Wang, Yuqi Zhang … Su Liu

Perioperative MedicineRandomized trialTreatmentQ1IF 6.0

Intranasal dexmedetomidine before surgery halved postoperative delirium after hip or knee arthroplasty

Effect of Intranasal Dexmedetomidine on the Night Before Surgery for Postoperative Delirium in Older Patients Undergoing Total Hip or Knee Arthroplasty: A Randomized Clinical Trial.

Yucheng Liu … Su Liu

Drug design, development and therapy · 2026

Background

IMPORTANCE: Postoperative delirium is a common and serious neurocognitive complication in elderly arthroplasty patients, with preoperative poor sleep as a key risk factor.

Purpose

To assess preoperative intranasal dexmedetomidine for preventing postoperative delirium in older adults undergoing hip or knee arthroplasty.

Methods

This was a single-center, double-blind, placebo-controlled randomized trial.

n = 232 elderly patients

Results

delirium risk cut about in half with dexmedetomidine vs placebo

RR 0.50 (95% CI 0.26 to 0.95)

CI excludes the null - significant

More results

Intranasal dexmedetomidine could improve sleep quality and reduce preoperative and postoperative anxiety and pain.

No severe adverse events or nasal mucosal injuries were observed in either group.

“

Conclusion · 1 of 2

Intranasal dexmedetomidine on the night before surgery could reduce the incidence of postoperative delirium and improve perioperative sleep quality in older patients undergoing joint arthroplasty.

Conclusion · 2 of 2

Sleep improvement may partly explain this association, suggesting a potential supportive strategy for delirium prevention.

Effect of Intranasal Dexmedetomidine on the Night Before Surgery for Postoperative Delirium in Older Patients Undergoing Total Hip or Knee Arthroplasty: A Randomized Clinical Trial.

Effect of Intranasal Dexmedetomidine on the Night Before Surgery for Postoperative Delirium in Older Patients Undergoing Total Hip or Knee Arthroplasty: A Randomized Clinical Trial.

Related papers