Date of Paper/Work

5-2011

Type of Paper/Work

Scholarly project

Degree Name

Master of Arts in Nursing

Department

Nursing

Advisor(s)

Teresa A. Kiresuk, DNP

Abstract

Postoperative delirium is especially common among the elderly. With advancements in health care, patients are undergoing surgery at an older age putting them at risk for delirium. Postoperative delirium results in more severe complications, higher costs, longer length of stay, and can be detrimental for friends and family. Health care professionals and family often wonder if postoperative delirium can be prevented. An extensive literature review was conducted to identify risk factors for postoperative delirium. For pharmacological agents studied, dexmedetomidine had a lower rate of delirium compared to propofol, midazolam, lorazepam, and morphine. Sevoflurane, COX-2 inhibitors, antipsychotics, and clonidine have resulted in lower rates of delirium in a limited number of studies. Therefore, further research is indicated. The following risk factors for postoperative delirium were identified: postoperative hypoalbuminemia, postoperative hematocrit less than 30%, postoperative cardiogenic shock, postoperative acute infection, residing in an institution rather than independently before surgery, cardiac valve surgery, cognitive function impairment, hypertension, alcoholism, severity of atherosclerosis, older age, use of opioids, and use of benzodiazepines. The following literature review provides insight into the pharmacologic and non-pharmacologic risk factors for developing postoperative delirium, and measures for providers to reduce these risk factors in their surgical practice.

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