Prevention of Post-operative Delirium in the Elderly Using Pharmacological Agents
| Autor: | Patrice Tremblay, Susan Gold |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Gabapentin medicine.medical_treatment Urology MEDLINE Reviews law.invention post-operative 03 medical and health sciences 0302 clinical medicine Text mining delirium Randomized controlled trial prevention law Medicine 030212 general & internal medicine Intensive care medicine pharmacological agents Post operative delirium Rehabilitation business.industry Incidence (epidemiology) Clinical study design Anesthesia Delirium Geriatrics and Gerontology medicine.symptom business Gerontology 030217 neurology & neurosurgery Medical literature medicine.drug |
| Zdroj: | Canadian Geriatrics Journal |
| ISSN: | 1925-8348 |
| Popis: | Introduction Post-operative delirium (POD) is a serious surgical complication that can cause significant morbidity and mortality. It is associated with prolonged hospital stay, delayed admission to rehabilitation programs, persistent cognitive deficits, marked health-care costs, and more. The pathophysiology is multifactorial and not completely understood, which complicates the optimal management. Non-pharmacological measures have been the mainstay of treatment, but there has been an ongoing interest in the medical literature on the prevention of post-operative delirium using medications. The purpose of this review is to critically analyze the current evidence on pharmacological prevention of POD. Methods A literature review was conducted using PubMed and Embase databases, using the following search terms: delirium, antipsychotics, cholinesterase inhibitors, and statins. Results A total of 1,152 articles were screened and 25 articles were reviewed. Fourteen articles found a reduced incidence of post-operative delirium using pharmacological agents: eight with antipsychotics, two with statins, one with melatonin, one with dexamethasone, one with gabapentin, and one with diazepam. However, study designs, methodological issues, or authors’ interpretations raise questions on these conclusions. Conclusions Further double-blinded randomized clinical trials should be conducted before administering pharmacological agents to reduce POD in a non-research setting. |
| Databáze: | OpenAIRE |
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