Study Design: Retrospective clinical review and prospective report of postoperative delirium after cervical spine surgeries.
Objective: To investigate factors contributing to the development of delirium after cervical surgery and see whether amended therapeutic protocols could improve or alter postoperative outcomes.
Summary Of Background Data: Important consequences of postoperative delirium for the orthopedic patients include impaired recovery and increased morbidity and mortality. Although its risk factors have been reported in orthopedic surgery, there are a very few reports regarding postoperative delirium in spine surgery.
Methods: Eighty-one cervical myelopathy patients were retrospectively examined about the incidence of postoperative delirium and the risk factors. Similarly, 41 patients who received postoperative care under modified protocols were prospectively examined.
Results: Postoperative delirium occurred more commonly in patients over 70 years and those with hearing impairment. Patients who received high-dose methylprednisolone (>1000 mg) demonstrated an increased incidence of postoperative delirium. Under modified protocol, we reduced the usage of methylprednisolone and encouraged free body movement with cervical orthosis immediately after surgery. The incidence of postoperative delirium was significantly lower under the modified protocol.
Conclusion: Early commencement of mobilization after cervical spine surgery would be crucial to the prevention of postoperative delirium in the elderly.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BRS.0b013e3181b321e6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effect of Clonidine on Duration of High-Volume, Low-Concentration Caudal Epidurals.
Cureus
December 2024
Anesthesiology and Perioperative Medicine, Medical University of South Carolina, Charleston, USA.
Introduction: Caudal blocks are a common pediatric regional anesthesia technique used to alleviate intra- and postoperative pain following circumcision. The addition of the alpha-2 agonist clonidine has been shown to increase the duration of the block. Another method for prolonging the effect of the block is using a high-volume, low-concentration (HVLC) local anesthetic in the caudal solution.
View Article and Find Full Text PDFEarly Screening for Confusion and Vitamin D Deficiency in Elderly Hip Fracture Patients: A Quality Improvement Initiative to Mitigate the Risk of Postoperative Delirium.
Cureus
December 2024
Psychiatry, The Redwoods Centre, Shrewsbury, GBR.
Background Postoperative delirium (POD) is a common and debilitating complication in elderly hip fracture patients, associated with significant clinical and functional consequences. Early identification of risk factors, such as cognitive impairment and vitamin D deficiency, is essential to mitigate its impact. However, preoperative screening practices are often inconsistent.
View Article and Find Full Text PDFComparison of bolus dose administration of propofol and dexmedetomidine for incidence of emergence delirium in pediatric patients undergoing surgery with general anesthesia: A randomized, double-blind trial.
J Anaesthesiol Clin Pharmacol
March 2024
Department of Paediatric Surgery, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
Background And Aims: Emergence delirium (ED) during the postanesthesia recovery phase presents significant challenges, especially among pediatric patients, with incidence rates spanning from 2% to 80%. This study sought to assess and compare the effectiveness of propofol and dexmedetomidine in addressing ED in pediatric patients undergoing sevoflurane anesthesia. The primary aim was to ascertain the prevalence of ED in both treatment cohorts, while secondary outcomes encompassed postoperative pain, hemodynamic responses, and the occurrence of complications.
View Article and Find Full Text PDFEfficacy of ultrasound-guided suprazygomatic maxillary nerve block on emergence agitation and postoperative analgesia after septorhinoplasty: A prospective randomized trial.
J Anaesthesiol Clin Pharmacol
July 2024
Department of Anesthesia, Surgical Intensive Care, and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Background And Aims: Emergence agitation (EA) is frequently encountered following nasal surgeries, and postoperative pain is a significant contributing element. We aimed to assess the role of suprazygomatic maxillary nerve (MN) block (SMB) guided by ultrasound (US) in lowering EA incidence and enhancing analgesia quality in septorhinoplasty cases.
Material And Methods: Sixty cases aged 18-60 years, of both genders, categorized by the American Society of Anesthesiologists (ASA) I-II and listed for septorhinoplasty, were randomized to receive general anesthesia (GA) with either no block (the control group) or combined with bilateral US-guided SMB (the SMB group).
The effect of type of anaesthetic on delirium after surgery for acute hip fracture: An instrumental variable analysis to assess causation.
Anaesth Intensive Care
January 2025
Neuroscience Research Australia (NeuRA), Sydney, Australia.
Delirium is the most common in-hospital complication affecting older adults with acute hip fractures. Current evidence demonstrates inconsistent associations between anaesthetic type for acute hip fracture surgery and postoperative delirium. Using the Australian and New Zealand Hip Fracture Registry database, we conducted a retrospective cohort study of patients aged 50 years and over who underwent acute hip fracture surgery between 2015 and 2020.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!