Delirium Perioperatorio

Related Factors and Treatment of Postoperative Delirium in Old Adult Patients: An Integrative Review

“…With respect to the pharmacological management of delirium, the most widely used drugs, according to the studies consulted, appear to be Haloperidol and Dexmedetomidine. However, it must be noted that there is no drug that is capable of totally eliminating the symptoms of postoperative delirium [8,9,11,20,21,24,27,[34][35][36]38,39,42,53,58,60,63,[76][77][78][79][106][107][108][109].…”

“…Haloperidol [8,9,11,15,16,33,47,54,64,70,74,78,81,89,92,94,97,102] Dexmedetomidine [8,10,11,15,16,33,37,47,54,64,70,78,81,89,94,97,102] Benzodiazepines [3,10,87,89,91] Olanzapine [9][10][11]15,47,75,82,97,115] Quetiapine [11,47,64,70,…”

“…McDaniel et al [34] established its incidence as 50%, with that of the hyperactive and mixed forms given as 25% in both cases. Rodríguez [11] stated that hyperactive delirium has an incidence of 5%, whereas the mixed and hypoactive types both have incidence rates of 45%. Guenther et al [35] stated that the hyperactive form has an incidence of 10%, and the hypoactive type has an incidence of more than 50%.…”

“…Patients have periods of lucidity, generally in the morning, with the maximum level of disturbance occurring at night. Unknown environments or those with few external stimuli aggravate the patient’s situation [ 10 , 11 ].…”

“…Postoperative delirium is associated with a multitude of complications, such as a longer length of stay in intensive care units [ 19 , 36 , 37 ] and longer hospital stays [ 6 , 38 , 39 , 40 , 41 ], as well as a higher cost per patient [ 7 , 41 , 42 , 43 , 44 , 45 ], a high incidence of subsequent discharge to nursing homes [ 23 , 46 , 47 ], and a greater likelihood of rehospitalization [ 6 , 14 ]. The pathology contributes to the appearance of cognitive changes [ 45 , 48 ] and permanent deterioration in function [ 37 , 49 , 50 , 51 ] and has been shown to be a precursor to dementia [ 11 , 33 , 40 , 42 , 52 ]. In the immediate postoperative period, the condition can also give rise to complications such as accidental removal of intravenous lines, haemorrhage at the site of surgery, and even aggression towards nursing personnel [ 21 ].…”