The effect of desflurane versus propofol anesthesia on postoperative delirium in elderly obese patients undergoing total knee replacement: A randomized, controlled, double-blinded clinical trial

Journal of Clinical Anesthesia
Pedro TanakaHendrikus J Lemmens

Abstract

The goal of this study was to investigate the incidence of delirium, wake-up times and early post-operative cognitive decline in one hundred obese elderly patients undergoing total knee arthroplasty. Prospective randomized trial. Operating room, postoperative recovery area, hospital wards. 100 obese patients (ASA II and III) undergoing primary total knee replacement under general anesthesia with a femoral nerve block catheter. Patients were prospectively randomized to maintenance anesthesia with either propofol or desflurane. The primary endpoint assessed by a blinded investigator was delirium as measured by the Confusion Assessment Method. Secondary endpoints were wake-up times and a battery of six different tests of cognitive function. Four of the 100 patients that gave informed consent withdrew from the study. Of the remaining 96 patients, 6 patients did not complete full CAM testing. Preoperative pain scores, durations of surgery and anesthesia, and amount of intraoperative fentanyl were not different between groups. One patient in the propofol group developed delirium compared to zero in desflurane. One patient in desflurane group developed a confused state not characterized as delirium. Fifty percent of the patients exhib...Continue Reading

Citations

Jan 23, 2018·Aesthetic Plastic Surgery·Mark C Kendall, Lucas J Castro-Alves
Feb 6, 2020·Anesthesia and Analgesia·Christopher G HughesUNKNOWN Perioperative Quality Initiative (POQI) 6 Workgroup
Jan 7, 2020·The British Journal of Surgery·M CarronM Foletto
Jul 28, 2018·Aging Clinical and Experimental Research·Yiru Wang, Xia Shen
Feb 20, 2020·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Stefanie BeckMarlene Fischer
Aug 14, 2018·Journal of Clinical Anesthesia·Mark C KendallChristopher J Malgieri

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