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术后谵妄

Postoperative delirium.

作者信息

Rengel Kimberly F, Pandharipande Pratik P, Hughes Christopher G

机构信息

Vanderbilt University Medical Center, department of anesthesiology, Nashville, TN, USA.

Vanderbilt University Medical Center, department of anesthesiology, Nashville, TN, USA.

出版信息

Presse Med. 2018 Apr;47(4 Pt 2):e53-e64. doi: 10.1016/j.lpm.2018.03.012. Epub 2018 Apr 19.

Abstract

Delirium in the perioperative period is a wide-reaching problem that directly affects important clinical outcomes. It is essential that anesthesiologists understand how to define and diagnose delirium, identify patients at high risk for developing delirium, recognize precipitating factors to appropriately adjust care plans, and manage patients who develop delirium in the acute postoperative period. Importantly, delirium remains underdiagnosed in the perioperative setting, but many screening and assessment tools are readily available to aid non-psychiatric trained personnel in identifying delirium. Finally, understanding and implementing strategies to prevent patients from developing delirium is of utmost importance, as evidence-based pharmacological treatments for delirium are minimal and have significant limitations.

摘要

围手术期谵妄是一个影响广泛的问题,直接影响重要的临床结局。麻醉医生必须了解如何定义和诊断谵妄,识别发生谵妄的高危患者,识别促发因素以适当调整护理计划,并管理术后急性期发生谵妄的患者。重要的是,围手术期环境中谵妄的诊断仍然不足,但有许多筛查和评估工具可供非精神科专业人员用于识别谵妄。最后,理解并实施预防患者发生谵妄的策略至关重要,因为基于证据的谵妄药物治疗很少且有显著局限性。

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