Intravenous anesthesia


Anesthesia and Pain Medicine. 2005 Sept. 9(3): 127-131
ⓒ Korean Society for Intravenous Anesthesia
Anesthetic Management of a Patient with a Recent History of Postoperative Delirium -A case report-
Hwa-Yong Shin, M.D., Yong-Min Choi, M.D., Kum-Suk Park, M.D., Hae-Kyoung Kim, M.D., Sang Hwan Do, M.D., and Seong-Deok Kim, M.D.
Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea

Delirium is defined as a disturbance of consciousness and an abrupt change in cognition that could not be accounted for by a prior history of dementia. The ability to focus, shift, or maintain attention is impaired; it develops over hours or days and fluctuates over the course of the day. Postoperative delirium is named when an acute change in cognition occurs within 30 days after operation. Outcomes associated with postoperative delirium include increased costs, longer hospital stay, decline in functional status and higher mortality rates. We present a case of anesthetic management of a patient with a recent history of postoperative delirium and other risk factors. The anesthetic management includes omission of preanesthetic medication, combined spinal-general anesthesia, epidural patient-controlled analgesia and oxygen supply during and after the operation.
Key words : combined spinal-general anesthesia, epidural patient-controlled analgesia, geriatric psychiatry, postoperative delirium
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