The effect of desflurane versus propofol anesthesia on postoperative delirium in elderly obese patients undergoing total knee replacement: A randomized, controlled, double-blinded clinical trial

Tanaka, Pedro Paulo; Goodman, Stuart B.; Sommer, Barbara R.; Maloney, William J.; Huddleston, James I.; Lemmens, Hendrikus J. M.

doi:10.1016/j.jclinane.2017.03.015

Cited by 43 publications

(37 citation statements)

References 39 publications

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“…We found total intravenous anesthesia using propofol‐sufentanil to increase the risk for PACU delirium compared with sevoflurane‐sufentanil anesthesia, even though the bispectral index target range was the same for all patients. The influence of anesthetic medication on neurocognitive function in general and postoperative delirium in particular has been the subject of some controversy owing to contradictory findings in previous studies . In a recent meta‐analysis the influence of propofol‐based total intravenous anesthesia on postoperative neurocognitive disorders was compared with inhalational agents for anesthesia maintenance .…”

Section: Discussionmentioning

confidence: 99%

Postanesthesia care unit delirium following robot‐assisted vs open retropubic radical prostatectomy: A prospective observational study

Beck

Hoop

Ragab

et al. 2020

Robotics Computer Surgery

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Background: The aim of this study was to compare the incidence of early postoperative delirium in the postanesthesia care unit (PACU) between robot-assisted radical prostatectomy (RARP) in the extreme Trendelenburg position and open retropubic radical prostatectomy (ORP) in supine position. Methods: Patients were screened for delirium signs 15, 30, 45, and 60 minutes following extubation.Results: PACU delirium was present in 39.3% of RARP (64/163) patients and 41.8% of ORP (77/184) patients. Higher age (OR 1.072, 95%CI: 1.034-1.111, P < .001), total intravenous anesthesia (OR 2.001, 95%CI: 1.243-3.221, P = .004), and anesthesia duration (OR 1.255, 95%CI: 1.067-1.476, P = .006) were associated with PACU delirium, but no association was found between surgical technique and PACU delirium.Conclusion: Compared with inhalational anesthesia, total intravenous anesthesia using propofol-sufentanil, higher age, and longer duration of anesthesia were associated with PACU delirium. Based on these findings, adverse effects on postoperative recovery and delirium signs do not have to be considered in the choice of surgical approach for radical prostatectomy.

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Section: Discussionmentioning

confidence: 99%

Postanesthesia care unit delirium following robot‐assisted vs open retropubic radical prostatectomy: A prospective observational study

Beck

Hoop

Ragab

et al. 2020

Robotics Computer Surgery

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“…Furthermore, comparing propofol and desflurane, 1 study demonstrated that the use of propofol impaired pulmonary function and SpO 2 to a greater degree than desflurane, 157 while another could not confirm these differences. 156 Thus, current evidence indicates that sevoflurane and desflurane might be superior to intravenous propofol in terms of anesthesia recovery in patients with obesity (Oxford LOE: 2).…”

Section: Intraoperative Medication Use In Patients With Osamentioning

confidence: 99%

Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea

Memtsoudis

Cozowicz

Nagappa

et al. 2018

Anesthesia &Amp; Analgesia

146

158

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The purpose of the Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea (OSA) is to present recommendations based on current scientific evidence. This guideline seeks to address questions regarding the intraoperative care of patients with OSA, including airway management, anesthetic drug and agent effects, and choice of anesthesia type. Given the paucity of high-quality studies with regard to study design and execution in this perioperative field, recommendations were to a large part developed by subject-matter experts through consensus processes, taking into account the current scientific knowledge base and quality of evidence. This guideline may not be suitable for all clinical settings and patients and is not intended to define standards of care or absolute requirements for patient care; thus, assessment of appropriateness should be made on an individualized basis. Adherence to this guideline cannot guarantee successful outcomes, but recommendations should rather aid health care professionals and institutions to formulate plans and develop protocols for the improvement of the perioperative care of patients with OSA, considering patient-related factors, interventions, and resource availability. Given the groundwork of a comprehensive systematic literature review, these recommendations reflect the current state of knowledge and its interpretation by a group of experts at the time of publication. While periodic reevaluations of literature are needed, novel scientific evidence between updates should be taken into account. Deviations in practice from the guideline may be justifiable and should not be interpreted as a basis for claims of negligence.

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“…In cardiac surgery, inhalation anesthetic agents are reportedly more bene cial than propofol in reducing PD; however, no relationship between anesthetic agents and PD has also been reported (Oh et al, 2017;Royse et al, 2011;Schoen et al, 2011). Similarly, these inconsistent results are observed in non-cardiac surgery (Ishii et al, 2016;Tanaka et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Postoperative Delirium According to the Intraoperative General Anesthetic Agents in Patients Undergoing Cardiac Surgery: a Retrospective and Propensity-Score Matched Study

Shin¹,

Choi²,

Na³

2020

Preprint

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Background: Cognitive alterations after cardiac surgery are a growing concern. We retrospectively evaluated the incidence of postoperative delirium (PD) in cardiac surgical patients according to the main anesthetic agent.Methods: The medical records of 534 patients, who had undergone heart valve surgery or coronary artery bypass graft surgery with cardiopulmonary bypass (CPB) between January 2012 and August 2017, were investigated. They were divided into two groups according to the main anesthetic agent: inhalation with dexmedetomidine (InDex group, n = 340) and propofol (propofol group, n = 194). The incidence of PD was evaluated as the primary outcome. Patient-, surgery-, and anesthesia-related factors and postoperative complications were investigated as secondary outcomes. To reduce the risk of confounder effects between the two groups, 194 patients were selected from the InDex group after propensity-score matching.Results: After propensity-score matching, the incidence of PD was not significantly different between the InDex (6.2%) and propofol (10.8%) groups (P = 0.136). In comparison of the incidence of each type of PD, only hyperactive PD occurred significantly less in the InDex group than in the propofol group (P = 0.021). Older age, lower preoperative albumin levels, and emergency surgery were significant risk factors for PD.Conclusions: The overall incidence of PD after cardiac surgery with CPB is not associated with the main anesthetic agents, inhalation and dexmedetomidine-based vs. propofol-based anesthesia. Only hyperactive PD occurred less frequently after in patients receiving inhalation and dexmedetomidine-based anesthesia.

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The effect of desflurane versus propofol anesthesia on postoperative delirium in elderly obese patients undergoing total knee replacement: A randomized, controlled, double-blinded clinical trial

Cited by 43 publications

References 39 publications

Postanesthesia care unit delirium following robot‐assisted vs open retropubic radical prostatectomy: A prospective observational study

Postanesthesia care unit delirium following robot‐assisted vs open retropubic radical prostatectomy: A prospective observational study

Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea

Prevalence of Postoperative Delirium According to the Intraoperative General Anesthetic Agents in Patients Undergoing Cardiac Surgery: a Retrospective and Propensity-Score Matched Study

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