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Strategies to prevent postoperative delirium: a comprehensive evaluation of anesthesia selection and drug intervention.
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 PDFModulating delirium through stimulation (MoDeSt): study protocol for a randomized, double-blind, sham-controlled trial assessing the effect of postoperative transcranial electrical stimulation on delirium incidence.
Trials
January 2025
Department of Neurology, Universitätsmedizin Greifswald, Fleischmannstraße 6, Greifswald, 17489, Germany.
Background: Postoperative delirium (POD) is the most common neurological adverse event among elderly patients undergoing surgery. POD is associated with an increased risk for postoperative complications, long-term cognitive decline, an increase in morbidity and mortality as well as extended hospital stays. Delirium prevention and treatment options are currently limited.
View Article and Find Full Text PDFBackground: Population aging and the increase in memory-related diseases have motivated the search for accessible cognitive screening instruments. To develop a digital memory and learning test (DMLT) based on Rey's Auditory Verbal Learning Test (RAVLT) principles to assess cognition in the elderly and identify early cognitive decline.
Methods: The research was divided into two phases: developing the digital test and the experimental phase of comparison with a reference test.
Background: Previously, a depth of anesthesia bispectral index (BIS™) <45 was considered lowand found to have no clinical benefit. A BIS <35 was considered very low and was not only without evident clinical benefit but also associated with a greater risk of postoperative delirium. We considered the association between BIS and the anesthetic dose of inhalational agents, quantified using the minimum alveolar concentration (MAC) fraction, which was the patient's end-tidal inhalational agent concentration divided by the agent's altitude- and age-adjusted minimum alveolar percentage concentration.
View Article and Find Full Text PDFA safety and feasibility randomized placebo controlled trial exploring electroencephalographic effective connectivity neurofeedback treatment for fibromyalgia.
Sci Rep
January 2025
Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, Otago, New Zealand.
Fibromyalgia is a chronic pain condition contributing to significant disability worldwide. Neuroimaging studies identify abnormal effective connectivity between cortical areas responsible for descending pain modulation (pregenual anterior cingulate cortex, pgACC) and sensory components of pain experience (primary somatosensory cortex, S1). Neurofeedback, a brain-computer interface technique, can normalise dysfunctional brain activity, thereby improving pain and function.
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