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ANESTHESIA ALERT
days) and tends to fluctuate over the course of a given day. Delirium,
on the other hand, is a formally recognized diagnosis, and a more relevant issue in ambulatory surgery.
STEPS YOU CAN TAKE
Preventing Post-Operative Delirium
Steps to take intraoperatively:
• Maintain adequate oxygenation and perfusion.
• Correct glucose and electrolytes.
• Adjust the doses of drugs and anesthesia as appropriate (anesthetic
requirements are lower in patients as they age).
• Use medications with short half-lives.
• Avoid central-acting anticholinergics, benzodiazepines and meperidine.
Post-operatively, you should do the following:
• Treat pain.
• Avoid drugs associated with delirium.
• Encourage earliest safe discharge to an environment that discourages
delirium and is conducive to normal sleep.
• Frequently reorient the patient.
• Mobilize and ambulate the patient.
• Appropriately hydrate the patient.
• Modify steps as necessary to make allowances for visual and hearing
impairment.
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— Christopher J. Jankowski, MD
O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J A N U A R Y 2013
