Effect of perioperative intranasal insulin on postoperative delirium in elderly hip fracture patients undergoing general anesthesia: a randomized controlled study

Oct 28, 2025BMC anesthesiology

Intranasal insulin during surgery and its link to delirium after hip fracture in elderly patients under general anesthesia

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Abstract

The incidence of (POD) was 10.9% in elderly patients receiving compared to 30.4% in the control group.

  • Postoperative delirium occurred in 20.7% of the overall study population.
  • Intranasal insulin administration was associated with a significant reduction in POD incidence within five days post-surgery.
  • On postoperative day 3, the insulin group showed a reduced POD incidence of 2.2%, compared to 19.6% in the control group.
  • Serum levels of interleukin-6 and C-reactive protein were significantly lower in the insulin group compared to controls on postoperative day 1.
  • Both groups experienced significant increases in interleukin-6 and C-reactive protein levels from baseline to postoperative day 1.

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Key numbers

10.9%
Decrease in Incidence
incidence in the insulin group within five postoperative days.
2.2%
Incidence at Day 3
incidence in the insulin group on postoperative day 3.
20.7%
Overall Incidence
Total incidence across both groups during the study.

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