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Objective:To investigate the effect of dexmedetomidine (Dex) on postoperative recovery quality, quantitative electroencephalogram and delirium in elderly patients with osteoporosis complicated with femoral neck fracture. Methods: 97 elderly patients with osteoporosis complicated with femoral neck fracture who were treated in our hospital from January 2016 to March 2021 were selected, they were randomly divided into control group (48 cases) and Dex group (49 cases) by the random number table method. Total hip arthroplasty was performed in both groups, and Dex group was given 0.5 μg/kg Dex before anesthesia induction, and the control group was given the same amount of normal saline. The wake-up quality, hemodynamic changes and quantitative electroencephalogram frequency of the two groups were observed, and the occurrence of delirium and adverse anesthetic reactions were recorded. Results: Compared with the control group, the respiratory recovery time, extubation time and eye-opening time in Dex group were earlier (P<0.05). The heart rate (HR) at surgical excision of skin (T2)~finish the operation (T4) time point in both groups was lower than that at before anesthesia (T1) time point, and the mean arterial pressure (MAP) was higher than that at T1 time point, the intra-group comparison difference was statistically significant (P<0.05). HR at T2~T4 time point in Dex group was higher than that in control group, MAP was lower than that in control group at corresponding time points (P<0.05). δ wave frequencies of left frontal region, right frontal region, left temporal region and right temporal region in both groups at 1d after operation were increased compared with those before operation, and the Dex group was lower than the control group (P<0.05). The α1 wave frequencies of left frontal region, right frontal region, left temporal region and right temporal region in both groups at 1d after operation decreased compared with those before operation, and Dex group was higher than control group (P<0.05). The incidence of postoperative delirium in Dex group was lower than that in control group (P<0.05). There was no statistical difference in the incidence of adverse anesthetic reactions between the two groups (P>0.05). Conclusion: Dex is given to elderly patients with osteoporosis complicated with femoral neck fracture during operation, can improve the quality of postoper ative recovery without aggravating blood flow fluctuation, alleviate the influence on the δ, α1 wave frequency of the frontal lobe of the patient, and it can reduce the incidence of delirium. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In hemiarthroplasty, the choice of prosthesis is particularly important, which directly affects the success rate of operation and postoperative complications. Hemiarthroplasty can be divided into bipolar hemiarthroplasty and unipolar hemiarthroplasty. This study systematically evaluated the clinical efficacy and safety of bipolar hemiarthroplasty and unipolar hemiarthroplasty in the treatment of displaced femoral neck fractures in the elderly so as to provide evidence-based support for prosthesis decision-making in hemiarthroplasty. METHODS: The databases including PubMed, The Cochrane Library, OVID, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database were searched to collect clinical randomized controlled trials of bipolar hemiarthroplasty and unipolar hemiarthroplasty for displaced neck femoral neck fractures in elderly patients at home and abroad. The Cochrane Handbook risk assessment tool was used to evaluate the quality of the included studies. The results of the included studies were meta-analyzed by RevMan 5.3 software. RESULTS: (1) Eighteen randomized controlled clinical trials with high quality were included, with a total of 1 988 fractures patients, including 998 cases in bipolar hemiarthroplasty group and 990 cases in unipolar hemiarthroplasty group. (2) There were no statistically significant differences in mortality, dislocation of prosthesis, loosening of prosthesis, local infection, hip pain, general complication, and surgical informations between bipolar hemiarthroplasty and unipolar hemiarthroplasty (P > 0.05). (3) Harris score was higher in the bipolar hemiarthroplasty group than that in the unipolar hemiarthroplasty group (MD=1.77, 95%CI:0.94-2.61, P < 0.001). The rate of acetabular erosion in bipolar hemiarthroplasty group was lower than that in unipolar hemiarthroplasty group (RR=0.25, 95%CI:0.13-0.47, P < 0.000 1). However, two studies have reported that bipolar implants may be more costly. CONCLUSION: Compared with unipolar hemiarthroplasty, bipolar hemiarthroplasty has lower acetabular wear rate and better recovery of hip function in elderly patients with displaced fem-oral neck fracture. However, whether bipolar prosthesis has better economic benefits than uni-polar prosthesis needs further evaluation in the future. [ABSTRACT FROM AUTHOR]