Influence of Intrathecal Dexamethasone Administration for Proximal Femoral Fractures

Impact of Intrathecal Dexamethasone Administration for Elderly Patients With Proximal Femoral Fracture

Spinal anesthesia blocks acute pain in older patients with femur fracture. Delirium is a common complication seen after femur fracture, affecting approximately 10-16% of patients. It is associated with increased mortality at 1st year, delayed rehabilitation efforts, prolonged length of hospital stay, poorer functional outcomes, and increased risk of nursing home placement.

Intrathecal dexamethasone administration improves quality of anesthesia in patients with femur fracture compared to conventional spinal anesthesia.

The aim of this research was to establish the influence of intrathecal dexamethasone administration in spinal anaesthesia with levobupivacaine on postoperative pain and changes of consciousness, values of cortisol levels and quality of treatment for patients with femoral fractures compared to spinal anaesthesia with only local anaesthetic.

The study was planned as a prospective, observational, randomised clinical trial. A total of 60 patients ASA2 and ASA3 status, scheduled for surgical procedures were sorted into two groups and underwent surgery in spinal anesthesia with levobupivacaine with or without dexamethsone.

Inclusion Criteria:

• cooperative ASA 2 and ASA 3 status patients with proximal femoral fractures of one leg
• agreed to be enrolled in the study (Informed Consent signed)

Exclusion Criteria:

• patients refused to be enrolled in the study
• patients with pre-existing cognitive disturbances before surgery
• conditions or diseases with corticosteroid therapy, long term corticosteroid, diabetes mellitus, neurological conditions or tumors, neuroendocrine disorders or tumors
• breaking the study protocols
• patients who no longer wanted to be enrolled in the study
• unexpected events when the study already started