From the Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
School of Nursing, University of Wisconsin, Madison, Wisconsin.
Anesth Analg. 2018 Feb;126(2):629-631. doi: 10.1213/ANE.0000000000002689.
Cognitive dysfunction 3 months after noncardiac surgery in the elderly satisfies informed consent thresholds of foreseeability in 10%-15% of patients, and materiality with new deficits observed in memory and executive function in patients with normal test performance beforehand. At present, the only safety step to avoid cognitive dysfunction after surgery is to forego surgery, thereby precluding the benefits of surgery with removal of pain and inflammation, and resumption of normal nutrition, physical activity, and sleep. To assure that consent for surgery is properly informed, risks of both cognitive dysfunction and alternative management strategies must be discussed with patients by the surgery team before a procedure is scheduled.
老年人非心脏手术后 3 个月出现认知功能障碍，在 10%-15%的患者中满足可预见的知情同意阈值，并且在术前测试表现正常的患者中观察到新的记忆和执行功能缺陷。目前，避免手术后认知功能障碍的唯一安全措施是避免手术，从而排除了手术去除疼痛和炎症、恢复正常营养、身体活动和睡眠的好处。为了确保手术同意书得到适当的知情同意，手术团队必须在安排手术前与患者讨论认知功能障碍和替代管理策略的风险。
