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KMID : 0377819910110040415
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Diagnosis and Treatment
1991 Volume.11 No. 4 p.415 ~ p.419
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POSTOPERATIVE DELIRIUM
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임태식/Lim, Tae Shik
김광수/유태열/Kim, Kwang Soo/Lew, Tae Yul
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Abstract
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Postoperative delirium is not rare, nor is it limited to -specific surgicai procedures or a specific type of patient. 10-15 percent incidence of general surgical patients age 65 and over was reported to be delirious after their operations, and a 78 percent of
eral surgical patients. Operations known to have a particularly high incidence of postoperative d elinurn include ophthalmologic procedures and cardiac surgery.
Postoperative delirium may not appear until third or fourth postoperative day and may be related to the cumulative effect of medications, metabolic disorders, decreased sensory input, and decreased sleep. Usually delirium comes onabruptly and is short-lived. Periods lasting longer than a week should alert the physician to search for additional specific causes prolonging the delirium.
In assessing the etiology of postoperative delirium, an accurate record of all the patient´s medicines with their total daily doses should be recorded, and specific attention should be paid tc narcotic analgesics, cardiac drugs, and any medications with anticholinergic activity.
The usual spectrum of toxic, metabolic, and infectious causes shuld be considered, as well as embolic phenomena in patients at risk.
Postoperative delirium requires energetic intervention when agitation, mood lability, hallucinations, and delusions pose a threat to medical management. We report a case of postoperative delirium with a brief review of literatures.
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