Preventing Postoperative Delirium
CA-2 · II.D.9.a.2 II.D.2.c.2 I.B.7.f
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The American Geriatrics Society guideline puts multicomponent non-pharmacologic intervention first for preventing delirium in at-risk older surgical patients, with pharmacologic measures secondary.
PMID 25495432
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Processed EEG guidance gave a pooled odds ratio of 0.78 for delirium that did not reach significance (P=0.054), with substantial heterogeneity between the nine trials.
PMID 35183345
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In patients over 65 admitted to intensive care after non-cardiac surgery, a low-dose dexmedetomidine infusion reduced delirium over the first seven days from 23% to 9%.
PMID 27542303
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Dexmedetomidine's effect on delirium is dose-dependent: cumulative doses at or below 0.49 micrograms per kilogram were associated with less delirium, while higher doses were not, with the lowest risk between 0.25 and 0.35.
PMID 41717663
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Whether deep anaesthesia is deliriogenic remains unsettled: the effect in the BALANCED delirium substudy appeared to rest on outcomes in patients from East Asia.
PMID 34503835
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Pooled across six trials in older non-cardiac surgical patients, dexmedetomidine reduced delirium and lowered tachycardia, hypertension, stroke and hypoxaemia — but increased bradycardia.
PMID 31419229
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