Comparison of incidence and risk factors of delirium between general and regional anesthesia in elderly patients after lower extremity surgery

Abstract

Purpose: The aim of this study is to compare the risk factors and the incidence of delirium following orthopedic surgery under the general or regional anesthesia in elderly patients. Material and Methods: One hundred twenty elderly patients aged and #8805;65 years scheduled for total hip or knee arthroplasty and femur fracture surgery were enrolled into the study. Patients were allocated into two groups to receive regional anesthesia (group R, n=50) or general anesthesia (group G, n=70). Hemodynamic and blood parameters, potential risk factors of delirium including age, sex, duration of surgery, the type of anesthesia, coexisting disease, smoking and amount of drug used delirium tests (Confusion Assessment Method, Delirium Rating Scale-Revised-98), hospital stay and costs were recorded for all patients. Results: Demographic data, duration of surgery, preoperative and postoperative hemodynamic and laboratory parameters were similar in two groups. Delirium incidence was 12.5% for all patients. We found delirium in six patients (8.6%) of group G and nine patients (18%) of group R. The most important risk factors were advanced age and polypharmacy for all patients. Hospital stay and cost were associated with severity of delirium. Conclusion: We found that the incidence of delirium is 12.5% in elderly patients undergoing total hip or knee arthroplasty and femur fracture surgery. Advanced age and polypharmacy are risk factors of delirium. Delirium increases the hospital stay and cost. [Cukurova Med J 2016; 41(1.000): 34-40]

Keywords

• General anesthesia
• regional anesthesia
• postoperative delirium