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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/31034


    標題: Incidence, risk factors, and phenomenological characteristics of postoperative delirium in patients receiving intravenous patient-controlled analgesia: a prospective cohort study
    作者: Lin, Yao Tsung
    Lan, Kuo Mao
    Wang, Li-Kai
    Chu, Chin-Chen
    Wu, Su-Zhen
    Chang, Chia-Yu
    Chen, Jen-Yin
    貢獻者: Chia Nan Univ Pharm, Chi Mei Med Ctr, Dept Anesthesiol
    Chia Nan Univ Pharm, Chi Mei Med Ctr, Dept Neurol
    Chia Nan Univ Pharm, Dept Senior Citizen Serv Management
    關鍵字: postoperative delirium
    postoperative analgesia
    patient-controlled analgesia
    screen
    日期: 2016
    上傳時間: 2018-01-18 11:40:17 (UTC+8)
    出版者: Dove Medical Press Ltd
    摘要: Background: Intravenous patient-controlled analgesia (IVPCA) is a common method of relieving pain which is a risk factor of postoperative delirium (POD). However, research concerning POD in IVPCA patients is limited. Objective: We aimed to determine the incidence, risk factors, and phenomenological characteristics of POD in patients receiving IVPCA. Methods: A prospective, cohort study was conducted in post-general anesthesia IVPCA patients aged. 60 years. POD was measured by the Nursing Delirium Screening Scale (NuDESC; 0-10). Delirium, pain severity at rest and/or on movement, and side effects of IVPCA during 3 postoperative days were examined twice-daily by the acute pain service team. Pain severity is measured by an 11-point verbal numerical rating scale (11-point VNRS) (0-10). An 11-point VNRS. 3 was considered inadequate pain relief. If POD (detected by NuDESC. 1) is suspected, consulting a neurologist or a psychiatrist to confirm suspected POD is required. Results: In total, 1,608 patients were included. The incidence rate of POD was 2.2%. Age >= 70 years and American Society of Anesthesiologists physical status. > III were the risk factors of POD in IVPCA patients. Approximately three-quarters of all POD cases occurred within the first 2 postoperative days. For pain at rest, patients with inadequate pain relief had significantly greater rates of POD than patients with adequate pain relief (day 1, 8.4% vs 1.5%, P<0.001; day 2, 9.6% vs 2.0%, P=0.028; day 3, 4.1% vs 2.1%, P= 0.412). However, the incidence of POD was not associated with movement-evoked pain relief. Most (79.9%) POD cases in IVPCA patients showed either one or two symptoms. The symptoms of POD were ranked from high to low as disorientation (65.7%), illusions/hallucinations (37.1%), inappropriate communication (31.4%), inappropriate behavior (25.7%), and psychomotor retardation (14.2%). Conclusion: The incidence rate of POD in IVPCA patients was low. Further research is warranted concerning POD and IVPCA pain management.
    Appears in Collections:[老人服務事業管理系] 期刊論文

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