Perioperative brain health:  The need to better understand this public health problem

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. During the course of our careers as physicians, we have cared for or are aware of an elderly patient in the intensive care unit or ward who has exhibited delirium, or an acute confused state. This is particularly common after surgery and anesthesia. While simply being in the hospital can lead to delirium, several questions remain. Have best practices and guidelines been fully implemented to decrease this risk? Are clinicians continuing to administer drugs to elderly patients and those with mild cognitive impairment that are known to increase the risk of delirium? Moreover, after these elderly patients return home from the hospital, we have all heard the stories of friends and family members who are not quite “the same” from the perspective of cognitive functioning.  This phenomenon usually resolves over days, but can sometimes linger for weeks and even months, threatening the patient’s well-being and return to independence. Accumulated evidence suggests that postoperative cognitive disorders are the single most common side effect of surgical care in the elderly. In fact, postoperative delirium can occur in up to 70 percent of patients depending on the surgery and if multiple diseases or conditions are present. This condition is likely related to the stress of hospitalization, surgery, and anesthesia, especially in a patient who already has mild cognitive impairment. Even when im...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Neurology Surgery Source Type: blogs