Utjecaj primjene deksametazona u spinalnoj anesteziji kod prijeloma bedrene kosti [Influence of dexamethasone administration in spinal anesthesia for femur fracture]

Proximal femur fractures are the most common cause of emergency admission to hospital with high postoperative morbidity. The hypothesis is that one single shot of dexamethasone with levobupivacaine in spinal anesthesia reduces postoperative pain and cognitive disturbances. The study included 60 patients with proximal femur fracture, ASA status 2 and 3 who were randomized into two groups. DLSA group received 8 mg of dexamethasone and 12.5 mg of 0.5% levobupivacaine intrathecally. LSA group received only levobupivacaine. The postoperative cognitive disturbance was evaluated with CAM-ICU score scale, the pain intensity was measured with VAS scale and cortisol and glucose samples were taken before and after surgery. Surgical correction was made in 63% of patients in 48 hours after admission. Ephedrine was used in LSA group, P=0,044. We found shorter hospitalization in DLSA group (P=0,045), shorter duration from surgery to discharge (P=0,044), there was lower occurrence of delirium and POCD (P=0,043), longer analgesia (P