Effect of Oral Melatonin Versus Intraoperative Lidocaine Infusion on Incidence of Postoperative Delirium in Elderly Patients Undergoing Total Hip Arthroplasty

NCT06768580 | Recruiting

• 1 other identifier: 36265MD277/9/24
• Study Type: interventional
• Target: 135
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to assess the effect of oral melatonin versus intraoperative lidocaine infusion on incidence of postoperative delirium in elderly patients undergoing total hip arthroplasty under spinal anesthesia.

Conditions

Oral Melatonin; Lidocaine Infusion; Postoperative Delirium; Elderly Patients; Total Hip Arthroplasty

Outcome Measures

Primary Outcomes (1)

• The incidence of postoperative delirium (POD)

  Incidence of postoperative delirium in elderly patients undergoing total hip arthroplasty will be recorded

  1st five days postoperatively

Secondary Outcomes (6)

• Severity of delirium

  1st five days postoperatively

• Onset of delirium

  1st five days postoperatively

• Duration of delirium

  1st five days postoperatively

• Degree of pain

  24 hours postoperatively

• Length of hospital stay

  Till the discharge from the hospital (up to 2 weeks).

Study Arms (3)

Melatonin group

EXPERIMENTAL

Patients will receive one capsule of melatonin (5mg) orally the night before surgery at 9 pm, the night of the operation, and two nights after the surgical operation at 9 pm, also the patients will receive 10 ml bolus of saline intravenous (IV) over 10 min before induction of anesthesia, then continuous infusion of saline (20 ml/hr) until the end of surgery.

Drug: Melatonin

Lidocaine group

EXPERIMENTAL

Patients will receive a bolus (10 ml) of intravenous lidocaine (1mg/kg) diluted with saline over 10 min before induction of anesthesia. Continuous infusion of 1.5 mg/kg/hr of intravenous lidocaine diluted with saline (20 ml/hr) will be administered until the end of the surgery, also will receive placebo capsule the night before surgery at 9 pm, the night of operation and two nights after the surgical operation at 9 pm.

Drug: Lidocaine

Control group

PLACEBO COMPARATOR

Patients will receive a bolus (10 ml) of saline over 10 min before induction of anesthesia, then continuous infusion of saline (20 ml/hr) and placebo capsule the night before surgery at 9 pm, the night of the operation and two nights after the surgical operation at 9 pm.

Drug: Placebo

Interventions

Melatonin DRUG

Patients will receive one capsule of melatonin (5mg) orally the night before surgery at 9 pm, the night of the operation, and two nights after the surgical operation at 9 pm, also the patients will receive 10 ml bolus of saline intravenous (IV) over 10 min before induction of anesthesia, then continuous infusion of saline (20 ml/hr) until the end of surgery.

Melatonin group

Lidocaine DRUG

Patients will receive a bolus (10 ml) of intravenous lidocaine (1mg/kg) diluted with saline over 10 min before induction of anesthesia. Continuous infusion of 1.5 mg/kg/hr of intravenous lidocaine diluted with saline (20 ml/hr) will be administered until the end of the surgery, also will receive placebo capsule the night before surgery at 9 pm, the night of operation and two nights after the surgical operation at 9 pm.

Lidocaine group

Placebo DRUG

Patients will receive a bolus (10 ml) of saline over 10 min before induction of anesthesia, then continuous infusion of saline (20 ml/hr) and placebo capsule the night before surgery at 9 pm, the night of the operation and two nights after the surgical operation at 9 pm.

Control group

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Elderly patients aged \>65 years old undergoing unilateral total hip arthroplasty.
• Patients with body mass index (BMI) (18-30) kg/m2.
• American Society of Anesthesiologists (ASA) physical status I-III, scheduled to undergo unilateral total hip arthroplasty.

You may not qualify if:

• History of mental illness or scoring less than 8 using abbreviated mental test (AMT) before operation.
• Obvious sinus bradycardia (heart rate of \<50 beats per minute) or other serious cardiovascular diseases.
• Symptomatic cerebrovascular disease (such as previous stroke).
• History of liver and kidney dysfunction.
• Allergy to lidocaine or melatonin.
• Metabolic disorders and fluid, electrolytes disturbances.
• Alcohol dependence or drug abuse.
• Redo surgery or infectious complications.
• CNS medications (antipsychotics, anticonvulsants, antiparkinsonian, antidepressants).
• History of deep vein thrombosis.

Sponsors & Collaborators

• Tanta University: lead

Study Sites (1)

Tanta University

Tanta, El-Gharbia, 31527, Egypt

RECRUITING

MeSH Terms

Conditions

Emergence Delirium

Interventions

Melatonin; Lidocaine

Condition Hierarchy (Ancestors)

Delirium; Confusion; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Neurocognitive Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Tryptamines; Indoles; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Heterocyclic Compounds; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Acetanilides; Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Central Study Contacts

Alshaimaa S Alasrag, Master

CONTACT

00201018940354; alshaimaa.alasrag@med.tanta.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.

Study Record Dates

• First Submitted: January 6, 2025
• First Posted: January 10, 2025
• Study Start: January 15, 2025
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2026
• Last Updated: April 15, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: After the end of study for one year.
• Access Criteria: The data will be available upon a reasonable request from the corresponding author

Locations

EG (1)