Background And Aims: Delirium is defined as an acute disturbance in consciousness along with impaired thought processing and easy distraction. Buprenorphine is a mixed agonist-antagonist opioid analgesic. Few case reports have been published about the possible association between buprenorphine and delirium. The aim of this study was to look for an association between buprenorphine and postoperative delirium in patients undergoing off-pump coronary artery bypass grafting (CABG) surgery.
Methods: Retrospective data from 100 cases of off-pump CABG were collected. The patients were divided into two groups (50 patients each). In group I, buprenorphine was used for postoperative analgesia. In group II, buprenorphine was not used for postoperative analgesia.
Results: On post-operative day 0, there was no incidence of delirium in both groups. On post-operative days two and three, there was no incidence of delirium in group II, but a statistically significant incidence of delirium was seen in group I ( = 0.012, relative risk >1). The overall (all four days) incidence of delirium was higher in group I which was statistically significant ( = 0.006). The total number of delirium cases was seven (14%) in group I and out of the seven delirium cases, five patients (10%) had hyperactive delirium, and two patients (4%) had hypoactive delirium.
Conclusion: Use of buprenorphine was associated with post-operative delirium, particularly of the hyperactive motoric subtype in off-pump CABG patients.
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http://dx.doi.org/10.4103/ija.ija_780_21 | DOI Listing |
PLoS One
January 2025
Department of Diagnostic and Health Sciences, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN, United States of America.
For patients hospitalized with COVID-19, delirium is a serious and under-recognized complication, and people experiencing homelessness (PEH) may be at greater risk. This retrospective cohort study compared delirium-associated risk factors and clinical outcomes between PEH and non-PEH. This study used patient records from 154 hospitals discharged from 2020-2021 from the Texas Inpatient Public Use Data file.
View Article and Find Full Text PDFJMIR Perioper Med
January 2025
Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, United States.
Background: Postoperative delirium (POD) is a common complication after major surgery and is associated with poor outcomes in older adults. Early identification of patients at high risk of POD can enable targeted prevention efforts. However, existing POD prediction models require inpatient data collected during the hospital stay, which delays predictions and limits scalability.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Weill Cornell Medicine, New York, NY, USA; St Vincent's Hospital, Melbourne, VIC, Australia.
Background: Postoperative delirium (POD) is a serious complication of surgery associated with prolonged hospitalisation, long-term cognitive decline, dementia and mortality. There is increasing evidence that electroencephalography (EEG) monitoring may reduce the incidence of POD, however, the best method for achieving this is unclear.
Method: This presentation will present the results of a multicentre randomised clinical trial of 515 at-risk patients undergoing major surgery from 8 centres in 3 countries who were assessed for POD for 5 days postoperatively.
Background: Delirium is a common neurological complication in older adults after a major illness or surgery and is characterized by acute dysfunction in cognition, attention, and awareness. Once diagnosed, it is associated with an increased risk for dementia. Frailty is an age-related syndrome and is associated with poorer postoperative outcomes, and is an emerging risk factor for delirium.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil.
Background: Although delirium is a powerful tool for identifying high-risk older patients at the emergency department (ED), the feasibility and importance of cognitive screening beyond delirium remain debated in fast-paced healthcare settings. We estimated the effect of comprehensive but pragmatic cognitive screening, capturing delirium and preexisting cognitive impairment, on predicting adverse outcomes within 90 days of admission in older adults at the ED.
Method: We conducted a prospective cohort study comprising patients aged ≥65 years who were consecutively admitted to the ED of a large general hospital in Sao Paulo, Brazil.
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