Patients prone for postoperative delirium

Guenther, Ulf; Riedel, Linda; Radtke, Frank‐Olaf

doi:10.1097/aco.0000000000000327

Cited by 44 publications

(23 citation statements)

References 91 publications

(70 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Only one patient showed all the five symptoms. This may be due to the effective pain treatment that decreases the risk and severity of POD 6–8. The most common symptom was disorientation, followed by illusions/hallucinations.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors of POD include old age, the American Society of Anesthesiologists (ASA) physical status of III or more, severe illness, types of surgery and anesthesia, postoperative hypoxemia, and severe acute pain 2–5. Interestingly, effective pain management reduces the incidence and severity of POD 6–8. Intravenous patient-controlled analgesia (IVPCA) is a common method of relieving postoperative pain.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence, risk factors, and phenomenological characteristics of postoperative delirium in patients receiving intravenous patient-controlled analgesia: a prospective cohort study

Lin¹,

Lan²,

Wang³

et al. 2016

NDT

View full text Add to dashboard Cite

BackgroundIntravenous patient-controlled analgesia (IVPCA) is a common method of relieving pain which is a risk factor of postoperative delirium (POD). However, research concerning POD in IVPCA patients is limited.ObjectiveWe aimed to determine the incidence, risk factors, and phenomenological characteristics of POD in patients receiving IVPCA.MethodsA prospective, cohort study was conducted in post-general anesthesia IVPCA patients aged ≥60 years. POD was measured by the Nursing Delirium Screening Scale (NuDESC; 0–10). Delirium, pain severity at rest and/or on movement, and side effects of IVPCA during 3 postoperative days were examined twice-daily by the acute pain service team. Pain severity is measured by an 11-point verbal numerical rating scale (11-point VNRS) (0–10). An 11-point VNRS >3 was considered inadequate pain relief. If POD (detected by NuDESC ≥1) is suspected, consulting a neurologist or a psychiatrist to confirm suspected POD is required.ResultsIn total, 1,608 patients were included. The incidence rate of POD was 2.2%. Age ≥70 years and American Society of Anesthesiologists physical status >III were the risk factors of POD in IVPCA patients. Approximately three-quarters of all POD cases occurred within the first 2 postoperative days. For pain at rest, patients with inadequate pain relief had significantly greater rates of POD than patients with adequate pain relief (day 1, 8.4% vs 1.5%, P<0.001; day 2, 9.6% vs 2.0%, P=0.028; day 3, 4.1% vs 2.1%, P=0.412). However, the incidence of POD was not associated with movement-evoked pain relief. Most (79.9%) POD cases in IVPCA patients showed either one or two symptoms. The symptoms of POD were ranked from high to low as disorientation (65.7%), illusions/hallucinations (37.1%), inappropriate communication (31.4%), inappropriate behavior (25.7%), and psychomotor retardation (14.2%).ConclusionThe incidence rate of POD in IVPCA patients was low. Further research is warranted concerning POD and IVPCA pain management.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence, risk factors, and phenomenological characteristics of postoperative delirium in patients receiving intravenous patient-controlled analgesia: a prospective cohort study

Lin¹,

Lan²,

Wang³

et al. 2016

NDT

View full text Add to dashboard Cite

show abstract

“…Opioids, in particular, should not be given routinely because side effects such as respiratory depression can be seen, especially in patients with sleep apnea [4], and even opioid-naïve patients who receive opioids in the perioperative period are at risk for long-term opioid use [5]. Furthermore, benzodiazepines and intravenous opioids may contribute to postoperative delirium in vulnerable patients, like the elderly [6]. …”

Section: Introductionmentioning

confidence: 99%

Virtual reality distraction decreases routine intravenous sedation and procedure-related pain during preoperative adductor canal catheter insertion: a retrospective study

Pandya

Kim

Howard

et al. 2017

Korean J Anesthesiol

View full text Add to dashboard Cite

BackgroundVirtual reality (VR) distraction is a nonpharmacological method to prevent acute pain that has not yet been thoroughly explored for anesthesiology. We present our experience using VR distraction to decrease routine intravenous sedation for patients undergoing preoperative perineural catheter insertion.MethodsThis 1-month quality improvement project involved all elective unilateral primary total knee arthroplasty patients who received a preoperative adductor canal catheter. Clinical data were analyzed retrospectively. For the first half of the month, all patients received usual care; intravenous sedation was administered at the discretion of the regional anesthesiologist. For the second half of the month, patients were offered VR distraction with intravenous sedation upon request. The primary outcome was fentanyl dosage; other outcomes included midazolam dosage, procedure-related pain, procedural time, and blood pressure changes.ResultsSeven patients received usual care and seven used VR. In the VR group, 1/7 received intravenous sedation versus 6/7 who received usual care (P = 0.029). The fentanyl dose was lower (median [10th–90th percentiles]) in the VR group (0 [0–20] µg) versus the non-VR group (50 [30–100] µg; P = 0.008). Midazolam use was lower in the VR group (0 [0–0] mg) than in the non-VR group (1 [0–1] mg; P = 0.024). Procedure-related pain was lower in the VR group (1 [1–4] NRS) versus the non-VR group (3 [2–6] NRS; P = 0.032). There was no difference in other outcomes.ConclusionsVR distraction may provide an effective nonpharmacological alternative to intravenous sedation for the ultrasound-guided placement of certain perineural catheters.

show abstract

“…3. Рутинним повинно бути визначення наявності у хворого делірію [10][11][12]13]. Якщо розцінювати делірій як синдром порушених розумових функцій, то рутинним має бути визначення стану когнітивних функцій.…”

Section: результати та обговоренняunclassified

“…4. Нефармакологічні заходи профілактики та лікування когнітивних розладів є необхідним компонентом як при застосуванні фармакологічних засобів, так і без них [10,12,13].…”

Section: результати та обговоренняunclassified

Базовые Принципы Профилактики Когнитивных Расстройств И Восстановление Когнитивных Функций При Критических Состояниях

Krishtafor¹

2021

ЕМ

View full text Add to dashboard Cite

підставі аналізу сучасних наукових публікацій, присвячених когнітивним розладам, обумовленим критичними станами, сформулювати базові принципи профілактики цих порушень і відновлення когнітивних функцій у групі хворих. Матеріали та методи. Дослідження проведено із залученням електронних бібліотек, пошукових систем і репозитаріїв наукових робіт:

show abstract

Patients prone for postoperative delirium

Cited by 44 publications

References 91 publications

Incidence, risk factors, and phenomenological characteristics of postoperative delirium in patients receiving intravenous patient-controlled analgesia: a prospective cohort study

Incidence, risk factors, and phenomenological characteristics of postoperative delirium in patients receiving intravenous patient-controlled analgesia: a prospective cohort study

Virtual reality distraction decreases routine intravenous sedation and procedure-related pain during preoperative adductor canal catheter insertion: a retrospective study

Базовые Принципы Профилактики Когнитивных Расстройств И Восстановление Когнитивных Функций При Критических Состояниях

Contact Info

Product

Resources

About