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Postoperative Confusion (postoperative + confusion)

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Medical Sciences100%

Selected Abstracts

Increased Cortisol Response to Surgery in Patients With Alcohol Problems Who Developed Postoperative Confusion

ALCOHOLISM, Issue 8 2004
Akira Kudoh
Background: Patients with alcohol problems often develop postoperative confusion and have impaired cortisol, ACTH, and norepinephrine. However, the relationship between neuroendocrine responses to surgical stress and postoperative confusion remains unclear in patients with alcohol problems. Methods: Plasma cortisol, ACTH, and norepinephrine concentrations during and after surgery in 30 patients with alcohol problems and 30 control patients who underwent lower abdominal surgery were measured before the induction of anesthesia, 15 and 60 min after skin incision, 60 min after the end of surgery, the next day, and the second day after the operation. Results: Plasma cortisol concentrations (21.2 ± 4.7 ,g·dl,1) of patients with alcohol problems before anesthesia were significantly higher than 15.6 ± 4.8 ,g·dl,1 of control patients. Plasma cortisol and ACTH responses to surgery in patients with alcohol problems were not significantly increased compared with preoperative values. The incidence of postoperative confusion was significantly higher in patients with alcohol problems than that of control patients (33% vs. 3%). Plasma cortisol concentrations (29.7 ± 7.0, 31.2 ± 6.6, 30.3 ± 8.0, and 28.4 ± 6.2 ,g·dl,1) 15 and 60 min after the skin incision, 60 min after the end of surgery, and the next day after operation in postoperatively confused patients with alcohol problems were significantly higher than those of nonconfused patients with alcohol problems (23.0 ± 5.8, 22.7 ± 4.1, 22.4 ± 7.2, and 21.9 ± 5.5 ,g·dl,1). Conclusion: The cortisol response to surgical stress increases in patients with alcohol problems who develop postoperative confusion, although cortisol response to surgical stress decreases in patients with alcohol problems without postoperative confusion. [source]

Postoperative confusion assessed with the Short Portable Mental Status Questionnaire

ANZ JOURNAL OF SURGERY, Issue 9 2003
Amirarsalan Eissa
Background: Confusion is a common occurrence after cardiac surgery. However, there is great variability in the reported incidence of confusion in patients following cardiac surgery, mainly due to the diagnostic methods and instruments employed in assessing confusion. Methods: Forty-eight cardiac surgery patients were assessed for postoperative confusion by a non-structured physician interview, and by the short portable mental status questionnaire (SPMSQ) administered by a medical student. Results: The non-structured ward interviews detected confusion in one of the 48 patients (2%), whereas the SPMSQ diagnosed confusion in 15 of the 48 patients (31%). Conclusion: Unlike a subjective ward interview, the SPMSQ is a brief and objective diagnostic tool that can be used to measure accurately both the presence and severity of confusion in postoperative cardiac surgery patients. [source]

Increased Cortisol Response to Surgery in Patients With Alcohol Problems Who Developed Postoperative Confusion

ALCOHOLISM, Issue 8 2004
Akira Kudoh
Background: Patients with alcohol problems often develop postoperative confusion and have impaired cortisol, ACTH, and norepinephrine. However, the relationship between neuroendocrine responses to surgical stress and postoperative confusion remains unclear in patients with alcohol problems. Methods: Plasma cortisol, ACTH, and norepinephrine concentrations during and after surgery in 30 patients with alcohol problems and 30 control patients who underwent lower abdominal surgery were measured before the induction of anesthesia, 15 and 60 min after skin incision, 60 min after the end of surgery, the next day, and the second day after the operation. Results: Plasma cortisol concentrations (21.2 ± 4.7 ,g·dl,1) of patients with alcohol problems before anesthesia were significantly higher than 15.6 ± 4.8 ,g·dl,1 of control patients. Plasma cortisol and ACTH responses to surgery in patients with alcohol problems were not significantly increased compared with preoperative values. The incidence of postoperative confusion was significantly higher in patients with alcohol problems than that of control patients (33% vs. 3%). Plasma cortisol concentrations (29.7 ± 7.0, 31.2 ± 6.6, 30.3 ± 8.0, and 28.4 ± 6.2 ,g·dl,1) 15 and 60 min after the skin incision, 60 min after the end of surgery, and the next day after operation in postoperatively confused patients with alcohol problems were significantly higher than those of nonconfused patients with alcohol problems (23.0 ± 5.8, 22.7 ± 4.1, 22.4 ± 7.2, and 21.9 ± 5.5 ,g·dl,1). Conclusion: The cortisol response to surgical stress increases in patients with alcohol problems who develop postoperative confusion, although cortisol response to surgical stress decreases in patients with alcohol problems without postoperative confusion. [source]

Postoperative confusion assessed with the Short Portable Mental Status Questionnaire

ANZ JOURNAL OF SURGERY, Issue 9 2003
Amirarsalan Eissa
Background: Confusion is a common occurrence after cardiac surgery. However, there is great variability in the reported incidence of confusion in patients following cardiac surgery, mainly due to the diagnostic methods and instruments employed in assessing confusion. Methods: Forty-eight cardiac surgery patients were assessed for postoperative confusion by a non-structured physician interview, and by the short portable mental status questionnaire (SPMSQ) administered by a medical student. Results: The non-structured ward interviews detected confusion in one of the 48 patients (2%), whereas the SPMSQ diagnosed confusion in 15 of the 48 patients (31%). Conclusion: Unlike a subjective ward interview, the SPMSQ is a brief and objective diagnostic tool that can be used to measure accurately both the presence and severity of confusion in postoperative cardiac surgery patients. [source]