Preoperative Treatment with Dexamethasone and Etoricoxib: A Comparison of Effects on Serum Interleukin-6 (IL-6) Levels and Postoperative Delirium (POD) in Geriatric Patients with General Anesthesia

Authors

  • Akbar Hasyim Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
  • Syafruddin Gaus Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
  • Nur Surya Wirawan Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
  • Andi Salahuddin Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
  • Andi Muhammad Takdir Musba Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
  • Andi Adil Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

DOI:

https://doi.org/10.18502/aacc.v12i6.22960

Keywords:

Dexamethasone; Etoricoxib; Interleukin-6; Postoperative delirium

Abstract

Background: In geriatrics, general anesthesia can cause a high incidence of postoperative delirium (POD), reaching 3-61%, characterized by elevated interleukin-6 (IL-6) levels. Dexamethasone is often used as an adjunct in anesthesia to reduce cognitive impairment, but it can cause psychiatric symptoms. Cyclooxygenase-2 inhibitors such as parecoxib have been reported to inhibit post-surgical inflammation levels and improve neurological and neurocognitive disorders. However, there are no reports on the use of etoricoxib and its comparison with dexamethasone for these effects. The objective was to analyze the comparison between preoperative administration of dexamethasone and etoricoxib on IL-6 levels and POD in geriatric patients with general anesthesia.

Methods: This randomized single-blind clinical trial study included 36 geriatric patients undergoing elective surgery who received therapy under general anesthesia and were randomly divided into three groups: placebo (group P, n = 12), dexamethasone 10 mg (group D, n = 12), and etoricoxib 90 mg (group E, n = 12). IL-6 levels were measured preoperatively, 6 hours, and 24 hours postoperatively using the ELISA method. POD was measured using the Confusion Assessment Method (CAM) both preoperatively and 24 hours postoperatively.

Results: The incidence of POD at 24 hours postoperatively was significantly lower in group E compared to groups P and D (p < 0.05). Changes in IL-6 levels at 6 hours and 24 hours postoperatively were significantly lower in group E compared to groups P and D (p < 0.05). There was a significant relationship between IL-6 levels at 6 hours postoperatively and CAM (r = 0.481; p < 0.05), and there was a significant relationship between IL-6 levels at 24 hours postoperatively and CAM (r = 0.537; p < 0.05).

Conclusion: Preoperative treatment with etoricoxib was more effective in suppressing IL-6 levels and the incidence of POD than dexamethasone and placebo.

Published

2026-10-19

Issue

Volume (12) issue (6)

Section

Articles