Delirium – a sudden state of confusion and memory problems – affects around one in seven older adults after an operation. People who get delirium spend longer in hospital, are more likely to die in hospital or develop dementia later in life.
The study, published in The BMJ, was conducted by researchers at NDORMS and the Nuffield Department of Clinical Neurosciences (NDCN), both at the University of Oxford, and supported by the National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre.
The principal author, NIHR Doctoral Research Fellow Dr Matthew Luney, said: 'Delirium is often unpleasant and distressing – for patients and their loved ones. It can slow recovery, lengthen hospital stays and often lead to long term health problems. This study brought together a great deal of existing research to help us identify which medications might help to prevent it after surgery.'
The research team analysed 158 clinical trials involving more than 41,000 participants aged 60 and over, using a 'network meta analysis' to compare the medicines and evaluate how effective each of them was.
They found that dexmedetomidine, a painkiller and sedative that also reduces inflammation, prevented delirium in almost every type of surgery. It reduced the number of people with delirium after surgery from 14 to seven per 100 people.