Tipos de prevenção no delirium pós-operatório
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Feb 21, 2023
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Resumo
Objetivo: Pesquisar sobre as possíveis formas de prevenir o delirium no pós-operatório. Métodos: Foi realizada uma revisão integrativa da literatura com abordagem qualitativa, com bases National Library of Medicine (PubMed) e Biblioteca Virtual em Saúde (BVS), com artigos publicados entre 2016 e 2021, disponíveis gratuitamente por completo em meio eletrônico e estudos do tipo ensaios clínicos, randomizados ou não randomizados, estudos de caso-controle e estudos de coorte. Resultados: Foram utilizados fármacos já conhecidos no meio hospitalar, com diversas posologias e formas de administração, e estratégias não medicamentosas na tentativa de evitar o surgimento do delirium. Dentre os artigos selecionados, 44% obtiveram sucesso na prevenção do delirium pós-operatório devido a interação das drogas utilizadas que atuaram na fisiopatologia desta doença. Considerações finais: O estudo evidenciou que é possível reduzir os números de incidência do delirium pós-operatório com certas drogas e, consequentemente prevenir esta patologia, todavia encontra limitações para padronizar este tratamento.
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Como Citar
SilvaM. C. L., FariaP. M., & FilippiA. C. Z. (2023). Tipos de prevenção no delirium pós-operatório. Revista Eletrônica Acervo Médico, 23(2), e12001. https://doi.org/10.25248/reamed.e12001.2023
Seção
Revisão Bibliográfica
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Referências
1. Al TMIMI L, et al. Intraoperative xenon for prevention of delirium after on-pump cardiac surgery: a randomised, observer-blind, controlled clinical trial. Br J Anaesth., 2020; S0007-0912(19): 31025-6.
2. AVIDAN MS, et al. Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial. Lancet, 2017; 390(10091): 267-275.
3. AZEEM TMA, et al. Dexmedetomidine vs morphine and midazolam in the prevention and treatment of delirium after adult cardiac surgery; a randomized, double-blinded clinical trial.Saudi J Anaesth 2018; 12(2): 190-197.
4. COBURN M, et al. The hip fracture surgery in elderly patients (HIPELD) study to evaluate xenon anaesthesia for the prevention of postoperative delirium: a multicentre, randomized clinical trial. Br J Anaesth., 2018; 120(1): 127-137.
5. DEINER S, et al. Intraoperative Infusion of Dexmedetomidine for Prevention of Postoperative Delirium and Cognitive Dysfunction in Elderly Patients Undergoing Major Elective Noncardiac Surgery: A Randomized Clinical Trial. JAMA Surg., 2017; 152(8): 171505.
6. FITZPATRICK S e OWEN K. Transtornos Cognitivos Pós-Operatórios: Delirium Pós-Operatório e Disfunção Cognitiva Pós-Operatória. Anesthesia tutorial of the week, 2018; 385: 2-6.
7. GAO F, et al. Transcutaneous electrical acupoint stimulation for prevention of postoperative delirium in geriatric patients with silent lacunar infarction: a preliminary study. Clin Interv Aging, 2018; 13: 2127-2134.
8. HE X, et al. Dexmedetomidine for the prevention of postoperative delirium in patients after intracranial operation for brain tumours (DEPOD study): a study protocol and statistical plan for a multicentre randomised controlled trial. BMJ Open, 2020; 10(11): 040939.
9. HOLLINGER A, et al. Ketamine vs. haloperidol for prevention of cognitive dysfunction and postoperative delirium: A phase IV multicentre randomised placebo-controlled double-blind clinical trial. J Clin Anesth 2021; 68: 110099.
10. JAISWAL SJ, et al. Ramelteon for Prevention of Postoperative Delirium: A Randomized Controlled Trial in Patients Undergoing Elective Pulmonary Thromboendarterectomy. Crit Care Med., 2019; 47(12): 1751-1758.
11. JANSSEN TL, et al. Multimodal prehabilitation to reduce the incidence of delirium and other adverse events in elderly patients undergoing elective major abdominal surgery: An uncontrolled before-and-after study. PLoS One, 2019; 14(6): 0218152.
12. JAVAHERFOROOSH Zadeh F, et al. Effect of Melatonin on Delirium After on-Pump Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial. Iran J Med Sci, 2021; 46(2): 120-127.
13. JIN L, et al. Ultrasound-guided continuous thoracic paravertebral block alleviates postoperative delirium in elderly patients undergoing esophagectomy: A randomized controlled trial. Medicine (Baltimore), 2020; 99(17): 19896-19896.
14. KHERA T, et al. Scheduled Prophylactic 6-Hourly IV AcetaminopheN to Prevent Postoperative Delirium in Older CaRdiac SurgicAl Patients (PANDORA): protocol for a multicentre randomised controlled trial. BMJ Open, 2021; 11(3): 044346.
15. LIKHVANTSEV VV, et al.Perioperative Dexmedetomidine Supplement Decreases Delirium Incidence After Adult Cardiac Surgery: A Randomized, Double-Blind, Controlled Study. J Cardiothorac Vasc Anesth., 2021; 35(2): 449-457.
16. MOSLEMI R, et al. Thiamine for Prevention of Postoperative Delirium in Patients Undergoing Gastrointestinal Surgery: A Randomized Clinical Trial. J Res Pharm Pract., 2020; 9(1): 30-35.
17. OH SC, et al. Effect of deep neuromuscular blockade on serum cytokines and postoperative delirium in elderly patients undergoing total hip replacement: A prospective single-blind randomised controlled trial. Eur J Anaesthesiol., 2021; 38(Suppl 1): S58-S66.
18. OMICHI C, et al. Association between discontinuation of benzodiazepine receptor agonists and post-operative delirium among inpatients with liaison intervention: A retrospective cohort study.Compr Psychiatry, 2021; 104: 152216.
19. SPIES C, et al. Physostigmine for prevention of postoperative delirium and long-term cognitive dysfunction in liver surgery: A double-blinded randomised controlled trial. Eur J Anaesthesiol., 2021; 38(9): 943-956.
20. SUSHEELA AT, et al. The use of dexmedetomidine and intravenous acetaminophen for the prevention of postoperative delirium in cardiac surgery patients over 60 years of age: a pilot study. F1000Res., 2017; 6(2): 1842.
21. SU X, et al. Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial. Lancet, 2016; 388(10054): 1893-1902.
22. TURAN A, et al. Dexmedetomidine for reduction of atrial fibrillation and delirium after cardiac surgery (DECADE): a randomised placebo-controlled trial. Lancet, 2020; 396(10245): 177-185.
23. UYSAL AI, et al. The effects of early femoral nerve block intervention on preoperative pain management and incidence of postoperative delirium geriatric patients undergoing trochanteric femur fracture surgery: A randomized controlled trial. Ulus Travma Acil Cerrahi Derg, 2020; 26(1): 109-114.
24. VLISIDES PE, et al. Perioperative Epidural Use and Risk of Delirium in Surgical Patients: A Secondary Analysis of the PODCAST Trial.Anesth Analg, 2019; 128(5): 944-952.
25. WADA S, et al. Yokukansan for perioperative psychiatric symptoms in cancer patients undergoing high invasive surgery. J-SUPPORT 1605 (ProD Study): study protocol for a randomized controlled trial. Trials, 2019; 20(1): 110-110.
26. XIN X, et al. Hypertonic saline for prevention of delirium in geriatric patients who underwent hip surgery. J Neuroinflammation, 2017; 14(1): 221-221.
2. AVIDAN MS, et al. Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial. Lancet, 2017; 390(10091): 267-275.
3. AZEEM TMA, et al. Dexmedetomidine vs morphine and midazolam in the prevention and treatment of delirium after adult cardiac surgery; a randomized, double-blinded clinical trial.Saudi J Anaesth 2018; 12(2): 190-197.
4. COBURN M, et al. The hip fracture surgery in elderly patients (HIPELD) study to evaluate xenon anaesthesia for the prevention of postoperative delirium: a multicentre, randomized clinical trial. Br J Anaesth., 2018; 120(1): 127-137.
5. DEINER S, et al. Intraoperative Infusion of Dexmedetomidine for Prevention of Postoperative Delirium and Cognitive Dysfunction in Elderly Patients Undergoing Major Elective Noncardiac Surgery: A Randomized Clinical Trial. JAMA Surg., 2017; 152(8): 171505.
6. FITZPATRICK S e OWEN K. Transtornos Cognitivos Pós-Operatórios: Delirium Pós-Operatório e Disfunção Cognitiva Pós-Operatória. Anesthesia tutorial of the week, 2018; 385: 2-6.
7. GAO F, et al. Transcutaneous electrical acupoint stimulation for prevention of postoperative delirium in geriatric patients with silent lacunar infarction: a preliminary study. Clin Interv Aging, 2018; 13: 2127-2134.
8. HE X, et al. Dexmedetomidine for the prevention of postoperative delirium in patients after intracranial operation for brain tumours (DEPOD study): a study protocol and statistical plan for a multicentre randomised controlled trial. BMJ Open, 2020; 10(11): 040939.
9. HOLLINGER A, et al. Ketamine vs. haloperidol for prevention of cognitive dysfunction and postoperative delirium: A phase IV multicentre randomised placebo-controlled double-blind clinical trial. J Clin Anesth 2021; 68: 110099.
10. JAISWAL SJ, et al. Ramelteon for Prevention of Postoperative Delirium: A Randomized Controlled Trial in Patients Undergoing Elective Pulmonary Thromboendarterectomy. Crit Care Med., 2019; 47(12): 1751-1758.
11. JANSSEN TL, et al. Multimodal prehabilitation to reduce the incidence of delirium and other adverse events in elderly patients undergoing elective major abdominal surgery: An uncontrolled before-and-after study. PLoS One, 2019; 14(6): 0218152.
12. JAVAHERFOROOSH Zadeh F, et al. Effect of Melatonin on Delirium After on-Pump Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial. Iran J Med Sci, 2021; 46(2): 120-127.
13. JIN L, et al. Ultrasound-guided continuous thoracic paravertebral block alleviates postoperative delirium in elderly patients undergoing esophagectomy: A randomized controlled trial. Medicine (Baltimore), 2020; 99(17): 19896-19896.
14. KHERA T, et al. Scheduled Prophylactic 6-Hourly IV AcetaminopheN to Prevent Postoperative Delirium in Older CaRdiac SurgicAl Patients (PANDORA): protocol for a multicentre randomised controlled trial. BMJ Open, 2021; 11(3): 044346.
15. LIKHVANTSEV VV, et al.Perioperative Dexmedetomidine Supplement Decreases Delirium Incidence After Adult Cardiac Surgery: A Randomized, Double-Blind, Controlled Study. J Cardiothorac Vasc Anesth., 2021; 35(2): 449-457.
16. MOSLEMI R, et al. Thiamine for Prevention of Postoperative Delirium in Patients Undergoing Gastrointestinal Surgery: A Randomized Clinical Trial. J Res Pharm Pract., 2020; 9(1): 30-35.
17. OH SC, et al. Effect of deep neuromuscular blockade on serum cytokines and postoperative delirium in elderly patients undergoing total hip replacement: A prospective single-blind randomised controlled trial. Eur J Anaesthesiol., 2021; 38(Suppl 1): S58-S66.
18. OMICHI C, et al. Association between discontinuation of benzodiazepine receptor agonists and post-operative delirium among inpatients with liaison intervention: A retrospective cohort study.Compr Psychiatry, 2021; 104: 152216.
19. SPIES C, et al. Physostigmine for prevention of postoperative delirium and long-term cognitive dysfunction in liver surgery: A double-blinded randomised controlled trial. Eur J Anaesthesiol., 2021; 38(9): 943-956.
20. SUSHEELA AT, et al. The use of dexmedetomidine and intravenous acetaminophen for the prevention of postoperative delirium in cardiac surgery patients over 60 years of age: a pilot study. F1000Res., 2017; 6(2): 1842.
21. SU X, et al. Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial. Lancet, 2016; 388(10054): 1893-1902.
22. TURAN A, et al. Dexmedetomidine for reduction of atrial fibrillation and delirium after cardiac surgery (DECADE): a randomised placebo-controlled trial. Lancet, 2020; 396(10245): 177-185.
23. UYSAL AI, et al. The effects of early femoral nerve block intervention on preoperative pain management and incidence of postoperative delirium geriatric patients undergoing trochanteric femur fracture surgery: A randomized controlled trial. Ulus Travma Acil Cerrahi Derg, 2020; 26(1): 109-114.
24. VLISIDES PE, et al. Perioperative Epidural Use and Risk of Delirium in Surgical Patients: A Secondary Analysis of the PODCAST Trial.Anesth Analg, 2019; 128(5): 944-952.
25. WADA S, et al. Yokukansan for perioperative psychiatric symptoms in cancer patients undergoing high invasive surgery. J-SUPPORT 1605 (ProD Study): study protocol for a randomized controlled trial. Trials, 2019; 20(1): 110-110.
26. XIN X, et al. Hypertonic saline for prevention of delirium in geriatric patients who underwent hip surgery. J Neuroinflammation, 2017; 14(1): 221-221.