Anesthetics do not cause Postoperative
Delirium in the Elderly
Newswise, October 18,
2011- A study presented at ANESTHESIOLOGY
2011 in Chicago this week offered firm
evidence that commonly used inhaled
anesthetics such as isoflurane do not
increase the incidence of postoperative
delirium, which can affect how well some
patients recover after surgery.
“Our study demonstrates that the use
of inhaled anesthetic agents does not increase the
incidence of cognitive problems such as delirium in the
early postoperative period,” said lead author Terri G.
Monk, M.D., Duke University Health System. “This study
should reassure elders that the type of general
anesthesia does not affect early cognitive outcomes
after surgery and that they should not avoid necessary
surgery or general anesthesia if it is required for
their surgery.”
Previous cellular and animal studies
have shown that some inhaled volatile anesthetics can
cause alterations in the brain similar to those seen in
dementia and Alzheimer’s disease. Dr. Monk’s current
study is one of the first human studies to address the
link between anesthesia and cognitive decline after
surgery.
Her prospective study enrolled 200
adults 65 or older who were undergoing major orthopedic
surgery. Before surgery, the patients were given tests
to determine brain function and depression levels.
During surgery, the patients received opioids with
either an inhaled anesthetic (isoflurane), or
intravenous anesthetic (propofol).
Postoperative delirium occurred in
12.6 percent of the patients receiving inhaled
anesthesia, and 13.6 percent of the patients receiving
intravenous anesthesia.
Importantly, it was found that only
the patient’s medical condition and cognitive status
before surgery had an effect on whether he or she would
experience delirium.
“These findings indicate that a
patient’s preoperative medical problems and the ability
to process information and concentrate (executive
function) and learn and remember (memory) are
independent predictors of postoperative delirium; the
type of general anesthesia does not influence the
incidence of postoperative delirium,” said Dr. Monk.
Patients who developed postoperative
delirium experienced a 40 percent orthopedic failure
rate, compared to a 5 percent failure rate for those
patients who did not experience delirium. Previous
studies have indicated that postoperative delirium is
associated with longer hospital stays and increased
morbidity and mortality.
The American Society of
Anesthesiologists
Anesthesiologists: Physicians providing the lifeline of
modern medicine. Founded in 1905, the American Society
of Anesthesiologists is an educational, research and
scientific association with 45,000 members organized to
raise and maintain the standards of the medical practice
of anesthesiology and improve the care of the patient.
For more information on the field of
anesthesiology, visit the American Society of
Anesthesiologists website atwww.asahq.org.
For patient information, visitLifelinetoModernMedicine.com.
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