Cargando…

Does using a femoral nerve block for total knee replacement decrease postoperative delirium?

BACKGROUND: The effect of peripheral nerve blocks on postoperative delirium in older patients has not been studied. Peripheral nerve blocks may reduce the incidence of postoperative opioid use and its side effects such as delirium via opioid-sparing effect. METHODS: A prospective cohort study was co...

Descripción completa

Detalles Bibliográficos
Autores principales: Kinjo, Sakura, Lim, Eunjung, Sands, Laura P, Bozic, Kevin J, Leung, Jacqueline M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364862/
https://www.ncbi.nlm.nih.gov/pubmed/22405052
http://dx.doi.org/10.1186/1471-2253-12-4
_version_ 1782234594633842688
author Kinjo, Sakura
Lim, Eunjung
Sands, Laura P
Bozic, Kevin J
Leung, Jacqueline M
author_facet Kinjo, Sakura
Lim, Eunjung
Sands, Laura P
Bozic, Kevin J
Leung, Jacqueline M
author_sort Kinjo, Sakura
collection PubMed
description BACKGROUND: The effect of peripheral nerve blocks on postoperative delirium in older patients has not been studied. Peripheral nerve blocks may reduce the incidence of postoperative opioid use and its side effects such as delirium via opioid-sparing effect. METHODS: A prospective cohort study was conducted in patients who underwent total knee replacement. Baseline cognitive function was assessed using the Telephone Interview for Cognitive Status. Postoperative delirium was measured using the Confusion Assessment Method postoperatively. Incidence of postoperative delirium was compared in two postoperative management groups: femoral nerve block ± patient-controlled analgesia and patient-controlled analgesia only. In addition, pain levels (using numeric rating scales) and opioid use were compared in two groups. RESULTS: 85 patients were studied. The overall incidence of postoperative delirium either on postoperative day one or day two was 48.1%. Incidence of postoperative delirium in the femoral nerve block group was lower than patient controlled analgesia only group (25% vs. 61%, P = 0.002). However, there was no significant difference between the groups with respect to postoperative pain level or the amount of intravenous opioid use. CONCLUSIONS: Femoral nerve block reduces the incidence of postoperative delirium. These results suggest that a larger randomized control trial is necessary to confirm these preliminary findings.
format Online
Article
Text
id pubmed-3364862
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-33648622012-06-01 Does using a femoral nerve block for total knee replacement decrease postoperative delirium? Kinjo, Sakura Lim, Eunjung Sands, Laura P Bozic, Kevin J Leung, Jacqueline M BMC Anesthesiol Research Article BACKGROUND: The effect of peripheral nerve blocks on postoperative delirium in older patients has not been studied. Peripheral nerve blocks may reduce the incidence of postoperative opioid use and its side effects such as delirium via opioid-sparing effect. METHODS: A prospective cohort study was conducted in patients who underwent total knee replacement. Baseline cognitive function was assessed using the Telephone Interview for Cognitive Status. Postoperative delirium was measured using the Confusion Assessment Method postoperatively. Incidence of postoperative delirium was compared in two postoperative management groups: femoral nerve block ± patient-controlled analgesia and patient-controlled analgesia only. In addition, pain levels (using numeric rating scales) and opioid use were compared in two groups. RESULTS: 85 patients were studied. The overall incidence of postoperative delirium either on postoperative day one or day two was 48.1%. Incidence of postoperative delirium in the femoral nerve block group was lower than patient controlled analgesia only group (25% vs. 61%, P = 0.002). However, there was no significant difference between the groups with respect to postoperative pain level or the amount of intravenous opioid use. CONCLUSIONS: Femoral nerve block reduces the incidence of postoperative delirium. These results suggest that a larger randomized control trial is necessary to confirm these preliminary findings. BioMed Central 2012-03-10 /pmc/articles/PMC3364862/ /pubmed/22405052 http://dx.doi.org/10.1186/1471-2253-12-4 Text en Copyright ©2012 Kinjo et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kinjo, Sakura
Lim, Eunjung
Sands, Laura P
Bozic, Kevin J
Leung, Jacqueline M
Does using a femoral nerve block for total knee replacement decrease postoperative delirium?
title Does using a femoral nerve block for total knee replacement decrease postoperative delirium?
title_full Does using a femoral nerve block for total knee replacement decrease postoperative delirium?
title_fullStr Does using a femoral nerve block for total knee replacement decrease postoperative delirium?
title_full_unstemmed Does using a femoral nerve block for total knee replacement decrease postoperative delirium?
title_short Does using a femoral nerve block for total knee replacement decrease postoperative delirium?
title_sort does using a femoral nerve block for total knee replacement decrease postoperative delirium?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364862/
https://www.ncbi.nlm.nih.gov/pubmed/22405052
http://dx.doi.org/10.1186/1471-2253-12-4
work_keys_str_mv AT kinjosakura doesusingafemoralnerveblockfortotalkneereplacementdecreasepostoperativedelirium
AT limeunjung doesusingafemoralnerveblockfortotalkneereplacementdecreasepostoperativedelirium
AT sandslaurap doesusingafemoralnerveblockfortotalkneereplacementdecreasepostoperativedelirium
AT bozickevinj doesusingafemoralnerveblockfortotalkneereplacementdecreasepostoperativedelirium
AT leungjacquelinem doesusingafemoralnerveblockfortotalkneereplacementdecreasepostoperativedelirium