Postoperative cognitive impairment in the elderly. Choice of patient-controlled analgesia opioid
| Autor: | C. A. Moote, Joyce Kirkby, W. Komar, W. Dobkowski, Michael Eliasziw, Sugantha Ganapathy, Ian A. Herrick |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_treatment Fentanyl law.invention Randomized controlled trial law Medicine Humans Postoperative Period Confusion Aged Aged 80 and over Pain Postoperative Morphine business.industry Urinary retention Patient-controlled analgesia Cognition Analgesia Patient-Controlled Clinical trial Analgesics Opioid Anesthesiology and Pain Medicine Opioid Anesthesia Female Hip Prosthesis medicine.symptom business Cognition Disorders Knee Prosthesis medicine.drug |
| Zdroj: | Anaesthesia. 51(4) |
| ISSN: | 0003-2409 |
| Popis: | This study evaluated the safety and cognitive impact of patient-controlled analgesia with fentanyl compared to patient-controlled analgesia with morphine among elderly postoperative patients. In addition, two screening tests for cognitive impairment, the Mini Mental Status Exam and the Short Portable Mental Status Questionnaire, were compared. Ninety-six elderly patients were randomly allocated to receive patient-controlled analgesia with either fentanyl or morphine following hip or knee arthroplasty. Patients were evaluated postoperatively for clinical confusion, cognitive function test results, adequacy of analgesia, drug use and complications. Fentanyl produced less depression in postoperative cognitive function compared to morphine. The incidence of clinical confusion was not statistically different between groups (4.3% for fentanyl versus 14.3% for morphine). Fentanyl patients used more opioid based on a dose ratio of 100:1 suggesting that this dose ratio is inadequate. The incidence of urinary retention was lower in the fentanyl group. A poor agreement between the two tests of cognitive impairment mandates caution when peri-operative cognitive function is compared using different tests. |
| Databáze: | OpenAIRE |
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