There is a complex association between postoperative pain and postoperative delirium, which highlights the need for a more balanced approach to pain management that considers various risk factors. We emphasise the importance of comprehensive documentation and standardised monitoring to improve detection and management of postoperative delirium, ultimately enhancing patient outcomes. We advocate for a precision anaesthesia approach, which tailors care to individual patient profiles, as a potential solution to address these challenges.
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http://dx.doi.org/10.1016/j.bja.2024.10.006 | DOI Listing |
Front Psychiatry
December 2024
Department of Orthopedics, The Second Hospital of Anhui Medical University, Hefei, China.
Postoperative delirium (POD) represents a common neurological complication encountered predominantly among the elderly cohort undergoing surgical intervention for hip fractures. This phenomenon, particularly commonplace in geriatric populations with heightened preoperative risk profiles, pronounced comorbidities, and later stages of lifespan, poses complex clinical challenges. The impact of perioperative pharmacological interventions and anesthetic strategies on POD's emergence cannot be understated, as it may profoundly affect the length of hospital stays, rehabilitation milestones, and the overall mortality hazard.
View Article and Find Full Text PDFSci Prog
January 2025
Orthopaedics, Hospital Universitario Fundacion Santa Fe de Bogotá, Bogotá, Colombia.
Hospital admission due to fragility hip fracture has increased significantly in recent years. In patients with hip fracture, perioperative pain management is usually with opioids, whose dosage is difficult to adjust and have many side effects, especially in older adults. The purpose of this study was to determine the impact and the advantages of the implementation of the fascia iliaca blockade in older adults with hip fracture due to fragility included in the Orthogeriatric Clinical Care Center of the Fundación Santa Fe de Bogotá and the San José Infantil University Hospital in Bogotá, Colombia.
View Article and Find Full Text PDFCrit Care Med
January 2025
Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Objectives: Randomized clinical trials informing clinical practice (e.g., like large, pragmatic, and late-phase trials) should ideally mostly use harmonized outcomes that are important to patients, family members, clinicians, and researchers.
View Article and Find Full Text PDFZ Gerontol Geriatr
January 2025
Orthopedics and Trauma Surgery, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
A A Pract
January 2025
Anaesthesia and Critical Care Section, Academic Unit of Injury, Inflammation and Repair, University of Nottingham, Nottingham, UK.
Background: Hypotension during anesthesia for surgery for hip fracture is common and associated with myocardial injury, stroke, acute kidney injury, and delirium. We hypothesized that maintaining intraoperative blood pressure close to patients' preoperative values would reduce these complications compared to usual care.
Methods: A pilot feasibility patient- and assessor-blinded parallel group randomized controlled trial.
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