- Oh ES
- Leoutsakos JM
- Rosenberg PB
- et al.
Undergoing Orthopedic Surgery: The RECOVER Randomized Controlled Trial.
assessing the preventative effect of ramelteon on postoperative delirium (POD) in
older patients undergoing orthopedic surgery. They showed that ramelteon was not efficacious
for prevention of POD. The authors used a quadruple-masked randomized controlled design
including a consistent surgical operation (knee and hip surgery), and had attempted
to control most factors affecting the occurrence of POD, such as age, preoperative
physical self-maintenance scale, cognitive and sleep status, drug use, comorbidities,
durations of surgery and anesthesia, and others. All of these are strengths in this
study. To differentiate the real effect of one factor on primary endpoint in a randomized
controlled trial, however, all of other possible influencing factors must be standardized
for avoidance of potential bias. Other than a small sample and limitations described
by the authors in the discussion, we noted other methodological issues in this study
that were not addressed well.
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Effects of Ramelteon on the Prevention of Postoperative Delirium in Older Patients Undergoing Orthopedic Surgery: The RECOVER Randomized Controlled Trial.
Am J Geriatr Psychiatry. 2020 May 16; https://doi.org/10.1016/j.jagp.2020.05.006
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Re: Oh ES, et al. Effects of Ramelteon on the Prevention of Postoperative Delirium in Older Patients Undergoing Orthopedic Surgery: The RECOVER Randomized Controlled Trial. Am J Geriatr Psychiatry 2020 May 16: doi: 10.1016/j.jagp.2020.05.006.
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