scholarly journals Postoperative cognitive deficit in the elderly surgical patient

1999 ◽  
Vol 82 (2) ◽  
pp. 307-308 ◽  
Author(s):  
R H Rehman ◽  
P Kemp
2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Diana Nordquist ◽  
Thomas M. Halaszynski

Background. Elderly patients have unique age-related comorbidities that may lead to an increase in postoperative complications involving neurological, pulmonary, cardiac, and endocrine systems. There has been an increase in the number of elderly patients undergoing surgery as this portion of the population is increasing in numbers. Despite advances in perioperative anesthesia and analgesia along with improved delivery systems, monotherapy with opioids continues to be the mainstay for treatment of postop pain. Reliance on only opioids can oftentimes lead to inadequate pain control or increase in the incidence of adverse events. Multimodal analgesia incorporating regional anesthesia is a promising alternative that may reduce needs for high doses and dependence on opioids along with any potential associated adverse effects. Methods. The following databases were searched for relevant published trials: Cochrane Central Register of Controlled Trials and PubMed. Textbooks and meeting supplements were also utilized. The authors assessed trial quality and extracted data. Conclusions. Multimodal drug therapy and perioperative regional techniques can be very effective to perioperative pain management in the elderly. Regional anesthesia as part of multimodal perioperative treatment can often reduce postoperative neurological, pulmonary, cardiac, and endocrine complications. Regional anesthesia/analgesia has not been proven to improve long-term morbidity but does benefit immediate postoperative pain control. In addition, multimodal drug therapy utilizes a variety of nonopioid analgesic medications in order to minimize dosages and adverse effects from opioids while maximizing analgesic effect and benefit.


2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Teresa Ferreira ◽  
Filipe Orfao ◽  
Cesar Fonseca ◽  
Lara Guedes de Pinho

Introduction: The World Health Organization creates norms and guidelines for the adoption of good practices in health care that are provided to the surgical patient. In order to prevent and control infections associated with health care, the nurse must follow the guidelines for preparing the surgical patient for success. These infections can be particularly harmful to the elderly person given their vulnerability. The preoperative preparation, includes the trichotomy as one of the interventions to be performed, however, is one of the most controversial interventions that has caused in clinical practice, by the potential risk of infection in the surgical patient. Aim: To investigate the need for trichotomy, or removal of hair, in the preparation of the skin of the surgical patient, clarifying which is the most appropriate technique in the prevention of infection. Methodology: we conducted an umbrella review. The documentary research followed the consultation of bibliographic sources in the Cumulative Index to Nursing & Allied Health (CINAHL) and Public/Publisher Medline (PubMed) databases. The researched articles were grouped in a time horizon between 2011 and 2020. Afer data extraction, a narrative analysis was performed. Results: We found 40 articles from which 8 were selected. Conclusion: Trichotomy should be avoided by increasing the risk of infection of the surgical site. Innovative haircut and vacuum technologies can help in hair removal, mitigating the risk of contaminating the surgical incision. The timing of the trichotomy is not consensual among researchers.


2012 ◽  
Vol 25 (6) ◽  
pp. 908-913 ◽  
Author(s):  
Aline Cristina Martins Gratao ◽  
Luana Flávia da Silva Talmelli ◽  
Vanderlei José Haas ◽  
Sueli Marques ◽  
Luciana Kusumota ◽  
...  

To characterize the elderly with cognitive déficit, and family caregivers who live in the urban communit,y and to identify the caregiver burden. METHODS: An observational, cross-sectional study, conducted between January and July 2009. Seventy elderly (aged 65 and older) were assessed for cognitive deficit using the Mini Mental State Examination (MMSE); their 70 caregivers were evaluated by the Zarit Burden Scale (ZBS) and the Self Reporting Questionnaire (SRQ). The data were entered and validated by double entry in the MS Excel Program, and were analyzed using SPSS software, version 15.0. RESULTS: Of the caregivers, 47.1% were children. We obtained a mean for the ZBS of 30.3 (± 17.3) and 6.2 (± 3.2) for the SRQ, p <0.05, correlating lower scores of the MMSE with high scores on ZBS and SRQ. CONCLUSIONS: Cognitive deficit of the elderly was a predictive factor for burden and emotional distress of caregivers. Knowing the reduction of cognitive capacity related to caregiver burden is essential for preserving caregiver health.


2012 ◽  
Vol 115 (1) ◽  
pp. 207-208 ◽  
Author(s):  
Hiroyuki Kinoshita ◽  
Noboru Hatakeyama ◽  
Yoshihiro Fujiwara

2008 ◽  
Vol 66 (2b) ◽  
pp. 298-302 ◽  
Author(s):  
Anália Nusya Garcia ◽  
Helker Albuquerque da Silva ◽  
Renan Carlos Silva ◽  
Eliane Maria Medeiros Leal ◽  
Lorena Rodrigues ◽  
...  

BACKGROUND: Polymorphism of the gene for apolipoprotein E (APOE) is an important risk factor for the development of Alzheimer's disease. The ε4 allele of the APOE gene has been linked with a number of neuropsychiatric illnesses, and also with stress and depression among geriatric populations. OBJECTIVE: To identify APOE-ε4 polymorphism and correlate this with cognitive deficit among the elderly population of the island of Fernando de Noronha. METHOD: Neuropsychiatric tests (mini-mental state examination, verbal fluency test and clock drawing test) were applied to 52 elderly people without Alzheimer's disease. DNA was isolated from peripheral blood and genotyping of APOE was done by the PCR-RFLP method. RESULTS: 87% of the elderly population (mean age 69.6±7.0) had cognitive deficit. CONCLUSION: The observed frequency of the ε4 allele was 10%, but the correlation between the presence of ε4 and cognitive deficit in this population was not statistically significant.


2017 ◽  
Author(s):  
Tracy S. Wang ◽  
Jennifer Roberts

The following is a detailed approach to the preoperative evaluation of the elderly surgical patient. A focus is placed on physiologic changes in the elderly that predispose them to complications and a systems-based approach to appropriate perioperative evaluation. Specifically, recommendations on the workup of cardiovascular, pulmonary, and renal systems are discussed. We also introduce the concept of frailty as a measure of an elderly patient's overall physiologic reserve. Finally, a diagnostic approach to common elderly-specific disease processes such as decreased functional status, malnutrition, and delirium is outlined. Throughout, an emphasis is placed on how to carefully assess this specific patient population and optimize preoperative functional status to improve surgical outcomes in the elderly. This review has 1 figure, 4 tables, and 62 references.


Sign in / Sign up

Export Citation Format

Share Document