Perioperative delirium is an acute confusional state with fluctuating levels of consciousness, which can be precipitated by opioid-based anesthetics and inadequate pain control, especially in patients undergoing cardiac surgery. We seek to minimize opioid usage to avoid postoperative delirium in a patient with multiple risk factors undergoing aortic valve replacement. We used cardiac enhanced recovery after surgery protocols (ERAS-C), which include multimodal analgesia and regional anesthesia via bilateral erector spinae plane (ESP) blocks. Our observations suggest that bilateral ESP blocks and cardiac ERAS protocols offer a potential option to manage pain and control risk factors in patients at high risk of postoperative delirium undergoing cardiac surgery.
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http://dx.doi.org/10.7759/cureus.25504 | DOI Listing |
J Gerontol A Biol Sci Med Sci
January 2025
Centro de Investigación Clínica Avanzada (CICA), Hospital Clínico Universidad de Chile.
Postoperative delirium (POD), an acute cognitive dysfunction linked to morbidity and mortality, is characterized by memory impairments and disturbances in consciousness, particularly in patients aged 65 and older. Neuroinflammation and NAD+ imbalance are key mechanisms behind POD, leading to synaptic and cognitive deterioration. However, how surgery contributes to POD and neuroinflammation remains unclear, and effective treatments are lacking.
View Article and Find Full Text PDFAm J Transl Res
December 2024
Department of Anesthesiology, Xi'an Central Hospital No. 161, Xiwu Road, Xincheng District, Xi'an 710003, Shaanxi, China.
Objective: To evaluate the effects of preemptive hydromorphone analgesia on postoperative delirium and stress response in patients undergoing laparoscopic cholecystectomy.
Methods: A retrospective cohort study was conducted, including 167 patients who underwent laparoscopic cholecystectomy at Xi'an Central Hospital between June 2021 and November 2023. Patients were categorized into an observation group (n=87) receiving preemptive hydromorphone hydrochloride analgesia and a control group (n=80) without preemptive analgesia.
BMC Surg
January 2025
Department of Anaesthesiology, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong, China.
Objective: The objective of this study was to develop and validate a clinically applicable nomogram for predicting the risk of delirium following hepatectomy.
Methods: We applied the LASSO regression model to identify the independent risk factors associated with POD. Subsequently, we utilized R software to develop and validate a nomogram model capable of accurately predicting the incidence of POD.
Korean J Anesthesiol
January 2025
Department of Anesthesiology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Jinsui Road 7th, Tianhe District, Guangzhou, Guangdong 510060, China.
Background: Emergence agitation (EA) occurs in preschool children after ophthalmic surgery as eye shields induce visual disturbance. We aimed to investigate the efficacy of light-transmitting eye shields as an alternative to traditional medical gauze eye shields for wound dressing in terms of EA incidence following strabismus surgery.
Methods: We randomly assigned 70 preschool children undergoing bilateral strabismus surgery to receive either light-transmitting (LT group, n = 35) or medical gauze (MG group, n = 35) eye shields upon the completion of surgery.
Psychogeriatrics
January 2025
Department of Anesthesiology, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China.
Background: Postoperative delirium (POD) poses significant clinical challenges regarding its diagnosis and treatment. Identifying biomarkers that can predict and diagnose POD is crucial for improving patient outcomes.
Methods: To explore potential biomarkers for POD, we conducted bulk RNA sequencing (bulk-seq) on peripheral blood samples from POD patients and healthy controls.
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