Document Detail


Delirium in the fast-track surgery setting.
MedLine Citation:
PMID:  23040285     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Postoperative delirium (PD) and postoperative cognitive dysfunction (POCD) are two separate syndromes of cognitive decline after major surgery, especially in the elderly. Pathogenesis is multifactorial with some common risk factors, and to reduce the risk, a multimodal approach is necessary. The fast-track methodology is becoming a well-established perioperative care regime with possible preventive effects for postoperative cognitive decline, including reduced pain and use of opioids, and early mobilisation with early discharge (≤3 days) to preoperative environment after total hip/knee arthroplasty (THA/TKA). The fast-track set-up seems to be associated with a lower frequency of PD and early POCD after THA/TKA. Thus, in a series of 225 patients ≥60 years, no cases of PD were seen and the incidence of POCD was reduced by more than 50% at 1 week postoperatively compared to previous studies. In conclusion, the fast-track methodology may reduce the incidence of postoperative cognitive decline after surgery.
Authors:
Lene Krenk; Lars S Rasmussen; Henrik Kehlet
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Best practice & research. Clinical anaesthesiology     Volume:  26     ISSN:  1878-1608     ISO Abbreviation:  Best Pract Res Clin Anaesthesiol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-10-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101121446     Medline TA:  Best Pract Res Clin Anaesthesiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  345-53     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
Affiliation:
Rigshospitalet, Section of Surgical Pathophysiology, 4074, The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty, Blegdamsvej 9, 2100 Copenhagen O, Denmark; Rigshospitalet, Department of Anaesthesia, Centre of Head and Orthopaedics, Section 4231, Blegdamsvej 9, 2100 Copenhagen O, Denmark. Electronic address: Lene.krenk@rh.regionh.dk.
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