Volatile anaesthetics and postoperative delirium in older surgical patients-A secondary analysis of prospective cohort studies.

Autor: Kinjo S; Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California., Lim E; Biostatistics Core Facility, Department of Complementary & Integrative Medicine, John A Burns School of Medicine, University of Hawaii, Honolulu, Hawaii., Magsaysay MV; Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California., Sands LP; Human Development Center for Gerontology, Virginia Polytechnic Institute and State University, Blacksburg, Indiana., Leung JM; Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California.
Jazyk: angličtina
Zdroj: Acta anaesthesiologica Scandinavica [Acta Anaesthesiol Scand] 2019 Jan; Vol. 63 (1), pp. 18-26. Date of Electronic Publication: 2018 Jul 27.
DOI: 10.1111/aas.13227
Abstrakt: Background: Volatile Anaesthetics (VAs) may be associated with postoperative delirium (POD). However, to date, the effects of VAs on POD are not completely understood. The objective of this study was to investigate the incidence of POD in different VA groups.
Methods: A secondary analysis was conducted using a database created from prospective cohort studies in patients who underwent elective major noncardiac surgery. Patients who received general anaesthesia with desflurane, isoflurane, or sevoflurane were included in the study. POD occurring on either of the first two postoperative days was measured using the Confusion Assessment Method.
Results: Five hundred and thirty-two patients were included in this study, with a mean age of 73.5 ± 6.0 years (range, 65-96 years). The overall incidence of POD on either postoperative day 1 or 2 was 41%. A higher incidence of POD was noted in the desflurane group compared with the isoflurane group (Odds Ratio = 3.35, 95% CI = 1.54-7.28). The incidence of POD between the sevoflurane and isoflurane or desflurane group was not statistically significant.
Conclusion: Each VA may have different effects on postoperative cognition. Further studies using a prospective randomized approach will be necessary to discern whether anaesthetic type or management affects the occurrence of postoperative delirium.
(© 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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