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Title: Effect of Dexamethasone on Post-Operative Delirium in adults following General Anaesthesia
Authors: Kazi Iftikhar Qureshi, Ali Aftab, Muhammad Asim Ghauri, Reema Yawar, Hatim Saifee, Tariq Mahmood
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2023
Volume: 73
Issue: 4
Language: English
DOI: 10.51253/pafmj.v73i4.6268
Keywords: DexamethasoneDeliriumGeneral anaesthesiaPost-operative
Objective: To determine the effect of Dexamethasone on post-operative delirium in adults following general anaesthesia among patients operated at Pakistan Navy Hospital Shifa.
Study Design: Prospective comparative study.
Place and Duration of Study: Anaesthesia and Pain Medicine Departments, Pakistan Navy Hospital Shifa, Karachi Pakistan, from Oct 2019 to Jan 2021.
Methodology: Patients operated in the main operation theatre of our hospital during the study period without any complication fulfilling the exclusion/inclusion criteria, were included in the study. They were randomly divided into two groups, with Group-A receiving 4mg Dexamethasone and other routine pre-anaesthetic medications. In contrast, Group-B just received the routine pre-anaesthetic medications but no Dexamethasone. An independent assessor assessed post-operative delirium using the Confusion assessment method (CAM).
Results: A total of 250 patients were included in the study, which met the inclusion criteria. The mean age of the study participants was 34.419±4.329 years. 27(10.8%) patients showed post-operative delirium, while 223(89.2%) did not show postoperative delirium on the Confusion assessment method. The chi-square test revealed that none of the factors studied, including the administration of pre-operative Dexamethasone, had any statistically significant relationship with the presence or absence of delirium among the target population (p-value >0.05).
Conclusion: Delirium was a fairly common finding in adult patients 24 hours after routine surgical procedures. None of the factors studied, including Dexamethasone, was related to the presence or absence of delirium in our study.
To determine the effect of Dexamethasone on post-operative delirium in adults following general anaesthesia among patients operated at Pakistan Navy Hospital Shifa.
Prospective comparative study conducted at Pakistan Navy Hospital Shifa, Karachi, Pakistan, from October 2019 to January 2021. Patients aged 18-65 years undergoing general anaesthesia for procedures lasting less than 90 minutes were included. Patients were randomly divided into two groups: Group-A received 4mg Dexamethasone plus routine pre-anaesthetic medications, and Group-B received only routine pre-anaesthetic medications. Post-operative delirium was assessed 24 hours post-procedure using the Confusion Assessment Method (CAM) by an independent, blinded assessor. Statistical analysis was performed using SPSS version 23.0, with the chi-square test for inferential statistics.
graph TD;
A["Patient Selection Inclusion/Exclusion Criteria"] --> B["Random Assignment to Groups"];
B --> C["Group A: Dexamethasone + Routine Meds"];
B --> D["Group B: Routine Meds Only"];
C --> E["Pre-anaesthetic Medication Administration"];
D --> E;
E --> F["General Anaesthesia and Surgery"];
F --> G["Post-operative Assessment CAM at 24 hrs"];
G --> H["Data Analysis Chi-square test"];
H --> I["Conclusion"];
Delirium is a common post-operative complication. In this study, approximately 10% of patients experienced post-operative delirium, and the use of Dexamethasone was not found to be significantly related to its presence or absence. The study acknowledges heterogeneous results in the literature regarding steroid use for preventing delirium and suggests that more studies with larger sample sizes and controlled confounding factors are needed.
A total of 250 patients were included. 27 (10.8%) patients showed post-operative delirium, while 223 (89.2%) did not. The chi-square test revealed no statistically significant relationship between the presence or absence of delirium and factors such as age, gender, presence of comorbidities, or the administration of pre-operative Dexamethasone (p-value > 0.05 for all).
Delirium was a fairly common finding in adult patients 24 hours after routine surgical procedures. None of the factors studied, including Dexamethasone, were found to be related to the presence or absence of delirium in this study.
1. Sample Size: 250 patients were included in the study. (Confirmed in Results section)
2. Delirium Incidence: 10.8% of patients (27 out of 250) showed post-operative delirium. (Confirmed in Results section)
3. Study Duration: The study was conducted from October 2019 to January 2021. (Confirmed in Methodology section)
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