| Title |
Incidence, risk factors, and phenomenological characteristics of postoperative delirium in patients receiving intravenous patient-controlled analgesia: a prospective cohort study
|
|---|---|
| Published in |
Neuropsychiatric Disease and Treatment, December 2016
|
| DOI | 10.2147/ndt.s119817 |
| Pubmed ID | |
| Authors |
Yao Tsung Lin, Kuo Mao Lan, Li-Kai Wang, Chin-Chen Chu, Su-Zhen Wu, Chia-Yu Chang, Jen-Yin Chen |
| Abstract |
Intravenous patient-controlled analgesia (IVPCA) is a common method of relieving pain which is a risk factor of postoperative delirium (POD). However, research concerning POD in IVPCA patients is limited. We aimed to determine the incidence, risk factors, and phenomenological characteristics of POD in patients receiving IVPCA. A prospective, cohort study was conducted in post-general anesthesia IVPCA patients aged ≥60 years. POD was measured by the Nursing Delirium Screening Scale (NuDESC; 0-10). Delirium, pain severity at rest and/or on movement, and side effects of IVPCA during 3 postoperative days were examined twice-daily by the acute pain service team. Pain severity is measured by an 11-point verbal numerical rating scale (11-point VNRS) (0-10). An 11-point VNRS >3 was considered inadequate pain relief. If POD (detected by NuDESC ≥1) is suspected, consulting a neurologist or a psychiatrist to confirm suspected POD is required. In total, 1,608 patients were included. The incidence rate of POD was 2.2%. Age ≥70 years and American Society of Anesthesiologists physical status >III were the risk factors of POD in IVPCA patients. Approximately three-quarters of all POD cases occurred within the first 2 postoperative days. For pain at rest, patients with inadequate pain relief had significantly greater rates of POD than patients with adequate pain relief (day 1, 8.4% vs 1.5%, P<0.001; day 2, 9.6% vs 2.0%, P=0.028; day 3, 4.1% vs 2.1%, P=0.412). However, the incidence of POD was not associated with movement-evoked pain relief. Most (79.9%) POD cases in IVPCA patients showed either one or two symptoms. The symptoms of POD were ranked from high to low as disorientation (65.7%), illusions/hallucinations (37.1%), inappropriate communication (31.4%), inappropriate behavior (25.7%), and psychomotor retardation (14.2%). The incidence rate of POD in IVPCA patients was low. Further research is warranted concerning POD and IVPCA pain management. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 38 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 38 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 8 | 21% |
| Student > Bachelor | 4 | 11% |
| Other | 3 | 8% |
| Student > Ph. D. Student | 2 | 5% |
| Student > Doctoral Student | 1 | 3% |
| Other | 5 | 13% |
| Unknown | 15 | 39% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 11 | 29% |
| Nursing and Health Professions | 4 | 11% |
| Business, Management and Accounting | 2 | 5% |
| Computer Science | 2 | 5% |
| Mathematics | 1 | 3% |
| Other | 4 | 11% |
| Unknown | 14 | 37% |
Attention Score in Context
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#20,656,820
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Outputs from Neuropsychiatric Disease and Treatment
#2,328
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Outputs of similar age from Neuropsychiatric Disease and Treatment
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