One hundred elderly patients undergoing hip fracture surgery were randomized to receive intraoperative intravenous lidocaine (n=50) or saline (n=50). The primary outcome of interest was the incidence of postoperative delirium in the first seven days after surgery. Secondary outcomes of interest included the severity of delirium, onset and duration of delirium, emergence agitation, adverse events, total propofol dose, intraoperative opioid dosage, length of post-anesthesia care unit stay, extubation time, and patient satisfaction with postoperative pain management. Outcomes were assessed up to seven days after surgery. Overall, the results of the study revealed that the incidence of postoperative delirium was significantly lower in the lidocaine group compared to the control group. Additionally, the lidocaine group had lower delirium severity scores and a reduced incidence of hypertension, tachycardia, and emergence agitation, without an increased risk of local anesthetic toxicity.