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Decrease in postoperative delirium in elderly patients with dementia

02/12/2010

Delirium is common after surgery, especially in older people with dementia (including Lewy body dementia. While delirium usually goes away in a few days, it can last longer, causing longer hospital stays, slower recovery times, and higher costs of care.

In a recent study at Johns Hopkins Medicine, hip fracture patients who were given spinal anesthesia and who were “lightly” sedated with propofal during surgery had fewer symptoms of delirium (changes in consciousness and attention) than patients who received spinal anesthesia and who were “heavily” sedated with propofal for the same operation.

Sedation is used during surgery, but also is routine in outpatient procedures including colonoscopy and cardiac catheterization, in the emergency room, and even in the dentist’s office. Before a person with LBD undergoes any surgery or procedure requiring sedation, caregivers should speak with the anesthesiologist about the risk of delirium or a decrease in functional ability. Because regional or spinal blocks are less likely to result in postoperative confusion, ask if these methods could be used instead of general anesthesia. If your loved one is taking donepezil, rivastigmine, or galantamine, ask your physician about the risks and benefits of stopping these medications before surgery.

Read more about the results of the study here.