Reply to: Intraoperative use of sodium oxybate to prevent post-operative delirium in older patients undergoing major orthopedic surgery

BACKGROUND: In our previously published article, we investigated the preventive efficacy of sodium oxybate against post-operative delirium (POD) in elderly patients undergoing orthopedic surgery and found that intraoperative sodium oxybate demonstrates possible time-specific efficacy, significantly reducing POD incidence exclusively in older patients undergoing morning orthopedic surgery. Main body In a Matters Arising correspondence, the authors raised several questions and suggestions regarding the methodology and interpretation of our findings. These concerns encompassed the control of perioperative factors, the definition and assessment of POD, as well as considerations related to post-operative pain management which may influence the effect of sodium oxybate on delirium prevention. We have provided point-by-point responses to each of these concerns and discussed directions for future research that may help address the limitations identified. CONCLUSIONS: In the Matters Arising, the authors put forward a number of constructive comments, to which we have responded accordingly. These insights provide valuable guidance for the design and conduct of future research in this area.