This study aims to determine whether, compared with placebo, the nighttime self-administration of a nasal dexmedetomidine is effective at inducing sleep and preventing postoperative delirium in high-risk patients.
Aged 65-90 years
Scheduled for a major abdominal surgery with estimated surgery time ≥ 2 hours
Blind, deafness or the inability to speak mandarin
Allergy to dexmedetomidine.
Renal and liver failure requiring dialysis or Child-Pugh score > 5
Follow-up difficulties (i.e. active substance abuse, psychotic disorder, homelessness)
Parallel
Dexmedetomidine
DrugIntranasal dexmedetomidine (100 µg total: 4 sprays, 25 µg/spray; Hengrui Medicine, China) self-administered preoperatively (\~9 PM) and optionally on the night of surgery (patient decides dose: 0, 2 sprays, or 4 sprays).
Placebo
DrugIntranasal water for injection (4 sprays, identical volume as nasal dexmedetomidine; Hengrui Medicine, China) self-administered preoperatively (\~9 PM) and optionally on the night of surgery (patient decides dose: 0, 2 sprays, or 4 sprays).
Incidence of postoperative delirium
Confusion Assessment Method
Delirium severity
Confusion Assessment Method Score
Physical activity
Fitbit Flex2 tracker
Sleep quality
Fitbit Flex2 tracker and Athens Insomnia Scale
Anxiety
Hamilton Anxiety Scale
Optional intranasal administration on the night of surgery
Optional intranasal administration of the same spray (patient decides dose: 0, 2 sprays, or 4 sprays)
Length of Hospital Stay
Medical Record Review
Cognitive function
Abbreviated Mental Test Score
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