Open AccessImplementation of strategies to prevent and treat postoperative delirium in the post-anesthesia caring unit
Author(s) -
Thomas Saller,
Klaus Hofmann-Kiefer,
Isabel Saller,
Bernhard Zwißler,
Vera von Dossow
Publication year - 2020
Publication title -
journal of clinical monitoring and computing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.591
H-Index - 51
eISSN - 1573-2614
pISSN - 1387-1307
DOI - 10.1007/s10877-020-00516-9
Subject(s) - delirium , medicine , anesthesiology , intensive care unit , pacu , emergence delirium , intensive care medicine , anesthesia , ambulatory , emergency medicine , surgery
Postoperative 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.