Abstract
AbstractPostoperative delirium is associated with worse outcome. The aim of this study was to understand present strategies for delirium screening and therapy in German Post-Anesthesia-Caring-Units (PACU). We designed a German-wide web-based questionnaire which was sent to 922 chairmen of anesthesiologic departments and to 726 anesthetists working in ambulatory surgery. The response rate was 30% for hospital anesthesiologists. 10% (95%-confidence interval: 8–12) of the anesthesiologists applied a standardised screening for delirium. Even though not on a regular basis, in 44% (41–47) of the hospitals, a recommended and validated screening was used, the Nursing Delirium Screening Scale (NuDesc) or the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). If delirium was likely to occur, 46% (43–50) of the patients were examined using a delirium tool. 20% (17–23) of the patients were screened in intensive care units. For the treatment of delirium, alpha-2-agonists (83%, 80–85) were used most frequently for vegetative symptoms, benzodiazepines for anxiety in 71% (68–74), typical neuroleptics in 77% (71–82%) of patients with psychotic symptoms and in 20% (15–25) in patients with hypoactive delirium. 45% (39–51) of the respondents suggested no therapy for this entity. Monitoring of delirium is not established as a standard procedure in German PACUs. However, symptom-oriented therapy for postoperative delirium corresponds with current guidelines.
Publisher
Springer Science and Business Media LLC
Subject
Anesthesiology and Pain Medicine,Critical Care and Intensive Care Medicine,Health Informatics
Reference25 articles.
1. Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin und Berufsverband Deutscher Anästhesisten (2009) Überwachung nach Anästhesieverfahren. Anaesthesiol Intensivmed 50:S486–9.
2. Sharma PT, Sieber FE, Zakriya KJ, Pauldine RW, Gerold KB, Hang J, Smith TH. Recovery room delirium predicts postoperative delirium after hip-fracture repair. Anesth Analg. 2005;101(4):1215–20. https://doi.org/10.1213/01.ane.0000167383.44984.e5.
3. Radtke FM, Franck M, Schust S, Boehme L, Pascher A, Bail HJ, Seeling M, Luetz A, Wernecke KD, Heinz A, Spies CD. A comparison of three scores to screen for delirium on the surgical ward. World J Surg. 2010;34(3):487–94. https://doi.org/10.1007/s00268-009-0376-9.
4. Radtke FM, Franck M, Schneider M, Luetz A, Seeling M, Heinz A, Wernecke KD, Spies CD. Comparison of three scores to screen for delirium in the recovery room. Br J Anaesth. 2008;101(3):338–43. https://doi.org/10.1093/bja/aen193.
5. Stukenberg S, Franck M, Spies CD, Neuner B, Myers I, Radtke FM. How can postoperative delirium be predicted in advance? A secondary analysis comparing three methods of early assessment in elderly patients. Minerva Anestesiol. 2016;82(7):751–9.
Cited by
11 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献