Abstract:
OBJECTIVE:The purpose of this study was to investigate the association between general (GA), regional (RA), and local (LA) anesthetic techniques with respect to the development of delirium after vascular surgery. The authors hypothesized that patients undergoing GA for vascular surgery would have a higher incidence of postoperative delirium. The role of LA with respect to postoperative delirium in vascular surgery patients previously has not been reported. DESIGN:Retrospective review. SETTING:Tertiary referral center, university hospital. PARTICIPANTS:500 patients undergoing vascular surgical procedures. INTERVENTIONS:Based on the chosen anesthetic technique, all patients were divided into GA, RA, and LA groups, respectively. Exclusion criteria were patients with preoperative dementia or abnormal level of consciousness, patients undergoing open abdominal aneurysm repair surgery, and patients undergoing carotid endarterectomy. All anesthetic techniques were conducted according to routine institutional practices. Patients in both the RA and LA groups received intravenous sedation. MEASUREMENTS AND MAIN RESULTS:Three hundred ninety-six (79%) patients received GA, 73 (15%) RA, and 31 (6%) LA. The overall incidence of delirium was 19.4% and rates were similar among the 3 groups, with 73 (18.4%) patients in the GA group, 17 (23.2%) in the RA group, and 7 (22.5%) in the LA group (p = 0.56). Patients in the LA group were more likely to have emergency surgery and also had a higher incidence of previous cerebrovascular accidents or transient ischemic attacks. There was no significant difference with respect to either onset or duration of delirium among the 3 groups. Median length of hospital stay and in-hospital mortality were similar among the 3 groups. CONCLUSIONS:Delirium rates after vascular surgery were similar with local, regional, or general anesthesia techniques. The presence of risk factors for the development of postoperative delirium should not influence the type of anesthesia provided.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Ellard L,Katznelson R,Wasowicz M,Ashworth A,Carroll J,Lindsay T,Djaiani Gdoi
10.1053/j.jvca.2013.12.003subject
Has Abstractpub_date
2014-06-01 00:00:00pages
458-61issue
3eissn
1053-0770issn
1532-8422pii
S1053-0770(13)00634-4journal_volume
28pub_type
杂志文章abstract::During the insertion of an automatic implantable cardioverter defibrillator, repeated induction of ventricular tachycardia or ventricular fibrillation and subsequent defibrillation is performed to determine the defibrillation threshold. In this study, the influence of these testing episodes on myocardial function was ...
journal_title:Journal of cardiothoracic and vascular anesthesia
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doi:10.1016/1053-0770(93)90167-j
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abstract::Advances in pediatric solid organ transplantation have furthered the understanding of end-organ failures and refined the strategies for perioperative management of these otherwise lethal diseases. As the donor pool expands, the number of transplantations increases and long-term survival continues to improve, more comp...
journal_title:Journal of cardiothoracic and vascular anesthesia
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journal_title:Journal of cardiothoracic and vascular anesthesia
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journal_title:Journal of cardiothoracic and vascular anesthesia
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journal_title:Journal of cardiothoracic and vascular anesthesia
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doi:10.1053/j.jvca.2006.01.015
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journal_title:Journal of cardiothoracic and vascular anesthesia
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.05.036
更新日期:2019-01-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
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journal_title:Journal of cardiothoracic and vascular anesthesia
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journal_title:Journal of cardiothoracic and vascular anesthesia
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journal_title:Journal of cardiothoracic and vascular anesthesia
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更新日期:2018-04-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
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更新日期:2008-06-01 00:00:00