RETRACTED: Effects of Dexmedetomidine on Postoperative Delirium and Expression of IL-1β, IL-6, and TNF-α in Elderly Patients After Hip Fracture Operation
Open accessAbstract
Objective: Postoperative delirium (POD) is a common surgical complication in elderly patients. This study investigated the effects of dexmedetomidine on POD and pro-inflammatory markers in elderly patients with hip fracture. Methods: This randomized, double-blind, controlled trial enrolled patients ≥65 years of age who underwent an operation for hip fracture at Beijing JiShuiTan Hospital from October 2016 to January 2017. The patients were divided into the DEX group (injected with dexmedetomidine 0.5 µg/kg/h) and the NS group (injected with normal saline). After surgery, the incidence of delirium at postoperative day 1 (T1), 2 (T2), and 3 (T3) was assessed using the Confusion Assessment Method delirium scale. Interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α blood levels were detected at T0 (before surgery), T1, and T3. Results: Data from 240 patients were analyzed, with 120/group (intent-to-treat analysis). Dexmedetomidine decreased POD incidence (18.2 vs. 30.6%, P = 0.033). Compared to T0, all three pro-inflammatory markers were higher at T1 and then decreased at T3 (time interaction, all P < 0.001). IL-6 (P < 0.001) levels were lower in the DEX group at T1, and TNF-α (P = 0.003) levels were lower in the DEX group at T1 and T3, but IL-1β levels were similar between the two groups. The rate of adverse events was similar in the two groups. Conclusion: Dexmedetomidine reduced the incidence of POD in elderly patients on the first day after hip fracture surgery, and reduced IL-6 and TNF-α levels over the first 3 days after surgery.
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Anti-inflammatory effects of α2A-AR agonists contribute to their widespread use as co-anesthetics in surgery, where they reduce incidence of emergence delirium.
“contribute to their widespread use as co-anesthetics in surgery, where they reduce the incidence of emergence delirium”
From Guanfacine’s mechanism of action in treating prefrontal cortical disorders: Successful translation across species (2020) · cites this paper as Zhang et al., 2020
The Results (Incidence of POD and NRS Scores; page unavailable) report less postoperative delirium with intraoperative dexmedetomidine, and the Discussion reports lower IL-6 and TNF-α levels. But the paper studies postoperative delirium in elderly hip-fracture patients, not emergence delirium, and does not establish that anti-inflammatory effects drive widespread use of α2A-AR agonists as co-anesthetics. The cited paper is marked retracted. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAnti-inflammatory effects of α2A-AR agonists are well-established.
“The anti-inflammatory effects of α2A-AR agonists are well-established”
From Guanfacine’s mechanism of action in treating prefrontal cortical disorders: Successful translation across species (2020) · cites this paper as Zhang et al., 2020
The Introduction describes dexmedetomidine as an α2-receptor agonist that can reduce systemic inflammation, and the Results report lower IL-6 and TNF-α levels in treated patients. The paper does not establish an effect specific to the α2A subtype or to α2A-AR agonists as a class, and its IL-1β results showed no difference between groups. Page numbers are unavailable in our copy. (LLM, conf=0.86)
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- Authors
- Zhang, W., Wang, T., Wang, G., Yang, M., Zhou, Y., & Yuan, Y.
- Affiliations
- Capital Medical University (CN)
- Beijing Jishuitan Hospital (CN)
- Corresponding author
- Wang, Tianlong
- Venue
- Frontiers in Pharmacology
- Publisher
- Frontiers Media SA
- Published
- 2020-05-12
- Volume
- 11
- Pages
- 678-678
- ISSN
- 1663-9812 (ISSN-L)
- PMC
- PMC7235357
- OpenAlex
- W3025260416
- Cited by
- 48
- References
- 28
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 14 · 2023: 12 · 2022: 7 · 2021: 9 · 2020: 1
- FWCI
- 4.60
- Type
- journal article
- Language
- en
- Status
- Retracted
- Update notices
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Pharmacology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Capital Medical University
- Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201813)
- Beijing Municipal Administration of Hospitals (ZYLX201813)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Keywords
- dexmedetomidine, postoperative delirium, hip fracture surgery, elderly patients, interleukin-6, IL-1β, TNF-α, inflammatory cytokines, retracted article
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