Preventative Delirium Protocol in Elderly Patients

Rush

Status: Completed

Conditions: Delirium

Treatments: Other: Control; Other: Preventative Delirium Protocol

Study type: Interventional

Funder types: Other

Identifiers

NCT03541408

Delirium

Details and patient eligibility

About

The current study aims to elucidate the effectiveness of a preventative delirium protocol in patients older than 65 years of age undergoing elective surgery.

Full description

A comprehensive analysis of patient specific risk factors and predisposing perioperative risk factors will be completed. The objective is to see if delirium incidences are significantly lower in the group that receives a preventative delirium protocol compared to a control group, while not increasing other adverse undesirable side effects. We hypothesize that a preventative delirium protocol will reduce the incidence of delirium compared to the control group (primary outcome), but this protocol may lead to increased side effects such as PONV, poor pain control, and increased awareness (secondary outcomes).

Enrollment: 263 patients

Sex: All

Ages: 65 to 89 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age > 65 years
• Scheduled for Elective Surgery (outpatient/same-day admit)

Exclusion criteria

• Need emergency surgery
• Need intracranial surgery
• Dependent on opiate narcotics
• Surgeon-specified perioperative procedures that precludes the current study's protocol

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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263 participants in 2 patient groups, including a placebo group

Control

Placebo Comparator group

Description:

Subjects will receive anesthesia

Treatment:

Other: Control

Preventative Delirium Protocol

Experimental group

Description:

* Consider regional block if applicable * Minimized fentanyl usage intraoperatively * Intubation + GA adjunct total: 1-2 mcg/kg * Sedation: 0-0.25 mcg/kg * Post-op: 0.5-1 mcg/kg * Avoid morphine * Avoid ketamine * Avoid diphenhydramine, dexamethasone, scopolamine, metoclopramide, and promethazine * Avoid H2-blockers (cimetidine, ranitidine, famotidine) * Avoid polypharmacy intraoperatively if possible (i.e. \>5 new medications) * Fluid repletion based on maintenance and losses

Treatment:

Other: Preventative Delirium Protocol