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CompletedNCT06945926Updated Aug 20, 2026

The Effect of Oxytocin Nasal Spray on Preventing Postoperative Delirium in Elderly Patients Undergoing Orthopedic Surgery

A Phase 2 interventional study of oxytocin nasal spray in Cervical Spinal Stenosis, Thoracic Spinal Stenosis and Lumbar Spinal Stenosis, sponsored by Zhejiang University. Completed at 1 site in China. Open to participants aged 65 Years and older. Per ClinicalTrials.gov, last updated 2026-08-20.

Sponsored by Zhejiang University · Phase 2, Interventional, and Prevention

Phase
Phase 2
Study type
Interventional
Enrollment
227
Allocation
Not applicable
Ages
65 Years and older
Sex
All
01

Study summary

Postoperative delirium is a delirium that occurs within 7 days after surgery or before hospital discharge. It has been shown that combined POD can increase the incidence of postoperative pulmonary infections, deep vein thrombosis and decubitus ulcers, and increase the incidence of disability and mortality. The incidence of postoperative delirium in geriatric orthopedics is high.

Investigators conduct a prospective clinical study on geriatric orthopedic surgery patients to investigate the effect of oxytocin nasal spray on the prevention of postoperative delirium in geriatric orthopedic surgery. Cases were included according to the inclusion and exclusion criteria, and induction, maintenance and resuscitation were performed according to the standard protocol for general anesthesia. Before the end of surgery, the Investigators administered oxytocin nasal spray (Oxytocin) that was 3 sprays in each nostril (4 IU each) for a total of 24 IU. Beginning 1 day postoperatively, administer 24 IU of oxytocin nasal spray 2 times/day in the morning and in the evening. Until 7 days after surgery or discharge. The sample size are 77 cases in phase I and 143 cases in phase 2, total 220 cases.

02

Conditions studied

  • Cervical Spinal Stenosis
  • Thoracic Spinal Stenosis
  • Lumbar Spinal Stenosis
  • Rotator Cuff Injury
  • Femoral Head Necrosis
  • Spinal Trauma
  • Knee Joint Injury

Keywords

  • Postoperative delirium
  • elderly orthopedics
  • oxytocin nasal spray
03

In context

Spinal Stenosis

459 studies on the registry are indexed under Spinal Stenosis; 103 are open to participants now.

This study's enrollment of 227 is above the median of 80 across 283 interventional studies indexed under Spinal Stenosis.

Browse Spinal Stenosis studies →

Lead sponsor

Zhejiang University is the lead sponsor of 351 studies on the registry; 165 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
65 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Elderly patients undergoing orthopedic surgery under general anesthesia

Inclusion criteria

Inclusion criteria:

  1. Age ≥ 65 years;
  2. Patients who were to undergo elective orthopedic surgery under general anesthesia with tracheal intubation;
  3. ASA class I-III;
  4. Estimated duration of surgery ≥ 1 hour; (5) The patient himself/herself or his/her legal representative;
  5. Informed consent from the patient or legal representative;
  6. Proficiency in the use of Chinese language for communication.

Exclusion criteria

Exclusion criteria:

  1. Nasal cavity occupation, patients with fillers in the nose
  2. Oxytocin allergy;
  3. Patients with previous psychiatric and neurological disorders, such as depression, severe central nervous system depression, Parkinson's disease, basal ganglia disease.

    Goldson's disease, basal ganglia lesions, schizophrenia, epilepsy, Alzheimer's disease, myasthenia gravis, and so on;

  4. Pregnant and lactating women
  5. Patients with severe hepatic insufficiency (Child-Pugh class C);
  6. patients with severe renal insufficiency (dialysis is required before surgery)
  7. Severe heart failure (METS\<4);
  8. Preoperative inability to communicate (coma or dementia);
  9. Severe preoperative blindness, deafness, or inability to understand Mandarin to complete preoperative delirium screening;
  10. Preoperative cognitive impairment as determined by a MoCA evaluation prior to surgery;
  11. Patients who are scheduled for 2 surgeries within 7 days of surgery;
  12. Patients with bone malignancy
  13. Currently participating in other clinical trials.
05

Study design

Phase
Phase 2
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
227 participants (actual)

Study arms

  • Experimental
    Oxytocin nasal spray given to geriatric orthopedic general anesthesia patients

    Cases were included according to the inclusion and exclusion criteria, and induction, maintenance and resuscitation were performed according to the standard protocol for general anesthesia.Before the end of anesthesia, the experimenter administered oxytocin nasal spray (Oxytocin) that was 3 sprays in each nostril (4 IU each) for a total of 24 IU. Beginning 1 day postoperatively, administer 24 IU of oxytocin nasal spray 2 times/day in the morning and 24 IU in the evening.Until 7 days after surgery or discharge.

    Drug: oxytocin nasal spray

Interventions

  • Drugoxytocin nasal spray

    Cases were included according to the inclusion and exclusion criteria, and induction, maintenance and resuscitation were performed according to the standard protocol for general anesthesia.Before the end of anesthesia, the experimenter administered oxytocin nasal spray (Oxytocin) that was 3 sprays in each nostril (4 IU each) for a total of 24 IU. Beginning 1 day postoperatively, administer 24 IU of oxytocin nasal spray 2 times/day in the morning and 24 IU in the evening.Until 7 days after surgery or discharge.

06

What researchers measure

Primary outcomes

  1. Incidence of postoperative delirium within 7 days after surgery.

    In the anesthesia recovery room, the CAM-ICU(The Confusion Assessment method for the ICU ) scale was performed 30 min after extubation. Postoperative delirium was measured by the 3D-CAM (The 3-Minute Diagnostic Confusion Assessment Method)scale from postoperative day 1 until postoperative day 7 or before discharge from the hospital. The CAM scale includes four major features: 1. Acute onset or fluctuating changes in condition 2. Inattention 3. Confusion 4. Changes in level of consciousness. Delirium is diagnosed when features 1 and 2 are positive at the same time, and/or features 3 and 4 are positive.

    Time frame: From the day of surgery to 7 days after surgery.Twice a day after surgery, once in the morning and once in the afternoon

Secondary outcomes

  1. The severity of postoperative delirium

    If the patient develops delirium, assess the severity with the MDAS( Memory Disorder Assessment Scale).The total score is 30 points, and the higher the score, the greater the degree of delirium

    Time frame: From the day of surgery to 7 days after surgery

  2. Length of hospitalization

    Recording the duration of hospitalization,Time from admission to discharge

    Time frame: 1 year

Other outcomes

  1. Time to extubation

    Time from discontinuation of anesthetic drugs to removal of endotracheal tube

    Time frame: Perioperative

  2. Time to PACU stay

    Time from entering the anesthesia recovery room to leaving the anesthesia recovery room

    Time frame: Perioperative

  3. Adverse reactions related to the experimental drugs.

    Adverse reactions Occasional symptoms of nasal irritation, nosebleeds, uterine bleeding, uterine hypercontractions and lacrimation

    Time frame: Within 7 days of surgery

  4. Postoperative complication

    Postoperative complications such as intraoperative knowledge, lung infection, nausea and vomiting

    Time frame: Perioperative, up to 1 weeks

  5. Time of catheter removal and first time out of bed

    Visiting patients daily, inquiring about their condition and keeping timely records

    Time frame: Perioperative, up to 1 weeks

07

Study locations

1 site
  • The First Affiliated Hospital, Zhejiang University School of Medicine
    Hangzhou, Zhejiang 310000, China
08

References and documents

Publications

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Individual participant data

Plan to share: Undecided

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 20, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06945926
Lead sponsor
Zhejiang University
Responsible party
Diansan Su (Chair of the Department of Anesthesiology, Zhejiang University) — Principal investigator
First posted
Apr 27, 2025
Start date
Jun 1, 2025
Primary completion
May 25, 2026
Completion
Jun 2, 2026
Last update
Aug 20, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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