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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Curr+Anesthesiol+Rep
2015 ; 5
(1
): 57-64
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Update on Pharmacotherapy for Prevention and Treatment of Post-operative
Delirium: A Systematic Evidence Review
#MMPMID25729334
Khan BA
; Gutteridge D
; Campbell NL
Curr Anesthesiol Rep
2015[Mar]; 5
(1
): 57-64
PMID25729334
show ga
Delirium is highly prevalent among elderly post-operative patients with no
pharmacological intervention approved by the Food and Drug Administration for
prevention or treatment. We conducted a systematic evidence review to critically
appraise literature related to the pharmacotherapy of post-operative delirium.
Ten studies fulfilled our inclusion criteria with two interventions for delirium
treatment and eight interventions for delirium prevention in post-operative
patients. The quality of evidence of delirium treatment studies was poor, whereas
the quality of evidence in delirium prevention studies ranges from moderate to
high. Delirium treatment studies find similar delirium duration and
length-of-stay outcomes between haloperidol and either morphine or ondansetron.
Risperidone was found to reduce the conversion of sub-syndromal delirium to
delirium in one study compared to placebo. Haloperidol, olanzapine, and ketamine
were each found to reduce delirium incidence, whereas rivastigmine had no impact
on delirium incidence or duration. Lighter anesthesia as monitored by bi-spectral
index led to a decreased delirium incidence. Considering results from studies
conducted prior to the dates of this review, the current evidence suggests that
certain pharmacologic classes and lighter sedation using BIS monitoring may
prevent post-operative delirium, although a conclusive recommendation for
clinical practice must await further research.