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SAN FRANCISCO — A longer preoperative period without fluids led to a higher incidence of postoperative delirium in the recovery room, Dr. Finn M. Radtke reported in a poster presentation at the annual meeting of the American Society of Anesthesiologists.
In his study of 516 patients, 45 (9%) who later developed delirium went without fluids for a median of 12 hours before surgery, compared with 10 hours for the 471 patients without delirium, a statistically significant difference. Delirium after surgical procedures is associated with increased morbidity and mortality, said Dr. Radtke of Charité School of Medicine-Berlin and his associates.
“There's no reason that a patient shouldn't get clear fluids until 2 hours before an operation,” Dr. Radtke said.
The study included adult patients who were moved to a recovery room after general anesthesia and surgery. It excluded patients who were undergoing neurosurgery or who had a history of psychiatric or immunologic illness. Nurses assessed patients in the recovery room using the Nursing Delirium Screening Scale, an observational five-item scale that can be completed within about a minute.
In addition to preoperative fluid fasting, the duration of anesthesia was associated with delirium in the recovery room. Patients with delirium had a significantly longer duration of anesthesia (a median of 150 minutes), compared with nondelirious patients (120 minutes), he reported. Similarly, patients with delirium stayed a median of 5 minutes longer in the recovery room than did their counterparts, a statistically significant difference.
A physician in the audience at the poster presentation commented, “I expected to see an older population in the delirium group, but there wasn't [a significant age difference].” The median age in the delirium group was 58 years, compared with 53 years in those without delirium.
The study did not assess the depth of anesthesia experienced by patients, which could have played some role in the risk for postoperative delirium, Dr. Radtke said. He said his hospital performs approximately 90,000 operations each year.
'There's no reason that a patient shouldn't get clear fluids until 2 hours before an operation.' DR. RADTKE
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SAN FRANCISCO — A longer preoperative period without fluids led to a higher incidence of postoperative delirium in the recovery room, Dr. Finn M. Radtke reported in a poster presentation at the annual meeting of the American Society of Anesthesiologists.
In his study of 516 patients, 45 (9%) who later developed delirium went without fluids for a median of 12 hours before surgery, compared with 10 hours for the 471 patients without delirium, a statistically significant difference. Delirium after surgical procedures is associated with increased morbidity and mortality, said Dr. Radtke of Charité School of Medicine-Berlin and his associates.
“There's no reason that a patient shouldn't get clear fluids until 2 hours before an operation,” Dr. Radtke said.
The study included adult patients who were moved to a recovery room after general anesthesia and surgery. It excluded patients who were undergoing neurosurgery or who had a history of psychiatric or immunologic illness. Nurses assessed patients in the recovery room using the Nursing Delirium Screening Scale, an observational five-item scale that can be completed within about a minute.
In addition to preoperative fluid fasting, the duration of anesthesia was associated with delirium in the recovery room. Patients with delirium had a significantly longer duration of anesthesia (a median of 150 minutes), compared with nondelirious patients (120 minutes), he reported. Similarly, patients with delirium stayed a median of 5 minutes longer in the recovery room than did their counterparts, a statistically significant difference.
A physician in the audience at the poster presentation commented, “I expected to see an older population in the delirium group, but there wasn't [a significant age difference].” The median age in the delirium group was 58 years, compared with 53 years in those without delirium.
The study did not assess the depth of anesthesia experienced by patients, which could have played some role in the risk for postoperative delirium, Dr. Radtke said. He said his hospital performs approximately 90,000 operations each year.
'There's no reason that a patient shouldn't get clear fluids until 2 hours before an operation.' DR. RADTKE
ELSEVIER GLOBAL MEDICAL NEWS
SAN FRANCISCO — A longer preoperative period without fluids led to a higher incidence of postoperative delirium in the recovery room, Dr. Finn M. Radtke reported in a poster presentation at the annual meeting of the American Society of Anesthesiologists.
In his study of 516 patients, 45 (9%) who later developed delirium went without fluids for a median of 12 hours before surgery, compared with 10 hours for the 471 patients without delirium, a statistically significant difference. Delirium after surgical procedures is associated with increased morbidity and mortality, said Dr. Radtke of Charité School of Medicine-Berlin and his associates.
“There's no reason that a patient shouldn't get clear fluids until 2 hours before an operation,” Dr. Radtke said.
The study included adult patients who were moved to a recovery room after general anesthesia and surgery. It excluded patients who were undergoing neurosurgery or who had a history of psychiatric or immunologic illness. Nurses assessed patients in the recovery room using the Nursing Delirium Screening Scale, an observational five-item scale that can be completed within about a minute.
In addition to preoperative fluid fasting, the duration of anesthesia was associated with delirium in the recovery room. Patients with delirium had a significantly longer duration of anesthesia (a median of 150 minutes), compared with nondelirious patients (120 minutes), he reported. Similarly, patients with delirium stayed a median of 5 minutes longer in the recovery room than did their counterparts, a statistically significant difference.
A physician in the audience at the poster presentation commented, “I expected to see an older population in the delirium group, but there wasn't [a significant age difference].” The median age in the delirium group was 58 years, compared with 53 years in those without delirium.
The study did not assess the depth of anesthesia experienced by patients, which could have played some role in the risk for postoperative delirium, Dr. Radtke said. He said his hospital performs approximately 90,000 operations each year.
'There's no reason that a patient shouldn't get clear fluids until 2 hours before an operation.' DR. RADTKE
ELSEVIER GLOBAL MEDICAL NEWS