880 the Effect of Opioid Administration by Different Routes on the Psychological Functions of Elderly Patients

İnan, Nurten; Çakan, Türkay; Özen, Mehmet Özgün; Aydin, Nesrin; Gürel, D.; Baltaci, Bülent

doi:10.1016/s1090-3801(06)60883-5

Cited by 3 publications

(7 citation statements)

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“…If the study was published within the last decade (timeframe within which there was a reasonable likelihood that data would be available), the corresponding author was emailed with a request for the necessary data. To this end, the authors of twelve studies were contacted (Blackburn, Qureshi, Amirfeyz, & Bannister, 2011;Brander et al, 2007;Cremeans-Smith, Soehlen, Greene, Alexander, & Delahanty, 2009;Davis et al, 2009;Faller, Kirschner, & K€ onig, 2003;Harden et al, 2003;Inan et al, 2007;Salazar et al, 2011;Stecz & Kocur, 2014b;Swinkels et al, 2009;Utrillas-Compaired, De la Torre-Escuredo, Tebar-Martinez, & Asunsolo-Del Barco, 2014;Wade et al, 2012); seven of whom provided the requisite data Davis et al, 2009;Faller et al, 2003;Salazar et al, 2011;Stecz & Kocur, 2014b;Swinkels et al, 2009;Utrillas-Compaired et al, 2014).…”

Section: Search Resultsmentioning

confidence: 99%

“…While accepted weighting methods were used (Lipsey & Wilson, 2001), the results from these studies may not be as generalizable to the broader TJR population. Finally, it was necessary to exclude an additional five studies because they did not provide all of the data needed to calculate an effect size and these data could not be obtained from the authors (Blackburn et al, 2011;Brander et al, 2007;Harden et al, 2003;Inan et al, 2007;Wade et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

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Depression and anxiety after total joint replacement among older adults: a meta-analysis

Scott

Mathias

Kneebone

2015

Aging & Mental Health

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TJR patients appear to have higher rates of clinically significant symptoms of depression before and after surgery, compared to the general population, however more research with adequate control groups is needed to confirm this. Only a modest improvement in the severity of depression and anxiety symptoms was noted post-surgery. However, existing research is limited; preventing definite conclusions regarding the impact of TJR on mood.

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Section: Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Depression and anxiety after total joint replacement among older adults: a meta-analysis

Scott

Mathias

Kneebone

2015

Aging & Mental Health

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“…When narcotic medications were used, morphine and meperidine appeared to be associated with an increased risk of postoperative cognitive dysfunction, irrespective of the mode of administration (IV, intramuscular [IM], or epidural). Inan et al [20] found no difference in postoperative cognitive dysfunction with the use of epidural versus IV PCA morphine and Colwell and Morris [7] reported no difference in complications, including confusion, with the use of IV PCA versus IM morphine postoperatively. However, Hartrick et al [16] and Herrick et al [18] reported a higher incidence of postoperative cognitive dysfunction with the use of morphine PCA as compared to fentanyl PCA, and Ilahi et al [19] found a higher incidence of postoperative cognitive dysfunction with the use of continuous epidural morphine as compared to fentanyl (23% versus 8%; p = 0.019).…”

Section: Multimodal Anesthetic Techniquesmentioning

confidence: 98%

“…However, of those studies, only nine of 21 (43%) explicitly reported blinding of patients, clinicians, and/or assessors to the participants' treatment arm allocation [4,12,15,20,24,27,29,47,48]. Only nine of 21 (43%) reported performing an a priori power calculation for the outcome of postoperative cognitive dysfunction [4,16,24,27,29,34,38,39,48], with one of these studies failing to recruit a sufficient number of patients [38].…”

Section: Study Designs and Populationsmentioning

confidence: 99%

“…This included eight studies of patients who underwent either TKA or THA [7,12,17,18,20,24,36,47], eight studies of patients who underwent unilateral TKA [15,19,26,35,39,41,45,48], two studies of patients who underwent unilateral THA [16,34], and one study of patients who underwent bilateral TKA [46]. The remaining nine studies encompassing 2426 patients investigated postoperative cognitive dysfunction in a mixed major noncardiac surgical population, which included patients who underwent elective joint arthroplasty.…”

Section: Study Designs and Populationsmentioning

confidence: 99%

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The Influence of Anesthesia and Pain Management on Cognitive Dysfunction After Joint Arthroplasty: A Systematic Review

Zywiel

Prabhu

Perruccio

et al. 2014

Clinical Orthopaedics &Amp; Related Research

103

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Background Despite the overall success of total joint arthroplasty, patients undergoing this procedure remain susceptible to cognitive decline and/or delirium, collectively termed postoperative cognitive dysfunction. However, no consensus exists as to whether general or regional anesthesia results in a lower likelihood that a patient may experience this complication, and controversy surrounds the role of pain management strategies to minimize the incidence of postoperative cognitive dysfunction.Questions/purposes We systematically reviewed the English-language literature to assess the influence of the following anesthetic and/or pain management strategies on the risk for postoperative cognitive dysfunction in patients undergoing elective joint arthroplasty: (1) general versus regional anesthesia, (2) different parenteral, neuraxial, or inhaled agents within a given type of anesthetic (general or regional), (3) multimodal anesthetic techniques, and (4) different postoperative pain management regimens. Methods A systematic search was performed of the MEDLINE 1 and EMBASE TM databases to identify all studies that assessed the influence of anesthetic and/or pain management strategies on the risk for postoperative cognitive dysfunction after elective joint arthroplasty. Twenty-eight studies were included in the final review, of which 21 (75%) were randomized controlled (Level I) trials, two (7%) were prospective comparative (Level II) studies, two (7%) used a case-control (Level III) design, and three (11%) used retrospective comparative (Level III) methodology.

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Intravenous patient-controlled analgesia does not increase the risk of postoperative delirium compared to patient-controlled epidural analgesia: a propensity score-matched retrospective cohort study

Miyoshi¹,

Nakamura²,

Noda³

et al. 2021

Ann Palliat Med

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Background: It is unclear whether the doses of opioids and the routes of administration used for postoperative analgesic management are associated with delirium. We aimed to compare the incidence of postoperative delirium (POD) between intravenous patient-controlled analgesia (IVPCA) and patientcontrolled epidural analgesia (PCEA) in patients who underwent postoperative analgesic management using opioids.Methods: We retrospectively investigated surgical patients (n=3,324) who received patient-controlled analgesia (PCA). Morphine was used for IVPCA, and fentanyl and ropivacaine were used for PCEA. The patients' background characteristics, perioperative management, presence of POD, and postoperative analgesia technique after IVPCA (n=1,184) or PCEA (n=2,140) were assessed. We divided the patients into IVPCA and PCEA groups and compared the incidence of POD by propensity score matching. We used the independent t-test for comparisons between the groups, and P<0.05 as considered as statistically significant.Results: POD was noted in a total of 125 patients (3.8%); 55 patients (4.6%) with IVPCA and 70 patients (3.3%) with PCEA (P=0.046). There was no statistically significant difference in cumulative opioid usage up to postoperative day 2 (in mg) between patients with and without POD (POD 62.7±39.8 vs. non-POD 48.9±50.3, P=0.10). After propensity score matching, 1,156 patients with similar baseline characteristics were selected. POD was noted in 22 of 578 patients (3.8%) in the IVPCA group and 30 of 578 patients (5.2%) in the PCEA group, with no difference between the two groups (P=0.256). On the other hand, opioid usage was higher in the IVPCA group than in the PCEA group (P<0.001).Conclusions: There was no difference in the incidence of POD between morphine IVPCA and fentanyl PCEA when the patient characteristics were matched using propensity score matching. POD occurs regardless of the route and dose of opioid administration.

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880 the Effect of Opioid Administration by Different Routes on the Psychological Functions of Elderly Patients

Cited by 3 publications

References 0 publications

Depression and anxiety after total joint replacement among older adults: a meta-analysis

Depression and anxiety after total joint replacement among older adults: a meta-analysis

The Influence of Anesthesia and Pain Management on Cognitive Dysfunction After Joint Arthroplasty: A Systematic Review

Intravenous patient-controlled analgesia does not increase the risk of postoperative delirium compared to patient-controlled epidural analgesia: a propensity score-matched retrospective cohort study

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