Prevent Post-op Brain Fog in Older Patients
We know who's likely to emerge from anesthesia confused and delirious.
A
nesthesia
and surgery
affect every-
one differently, but
there is evidence
that aging brains are
more vulnerable to
post-operative cog-
nitive decline
(POCD), which may
include post-opera-
tive cognitive dys-
function, confusion
or delirium. Post-operative delirium is the most common surgical
complication for older adults, but it's preventable in up to 40% of all
patients. Here are 4 tips from the American Society of
Anesthesiologists' Brain Health Initiative to screen for and diminish
confusion after surgery.
Screen for cognitive deficit. The goal is to help your geriatric
patients return to their pre-op cognitive baseline. Assessing
your patients' mental function not only gives you a baseline to com-
pare to after surgery, it also alerts you to patients who may have
mild cases of cognitive impairment.
Your cognitive test can be as simple as asking 1 or 2 questions to
assess the patient's mental function, or as involved as a neurocognitive
test. A negative response to the question "Can you remember things
you did 10 years ago?" warrants further cognitive testing. But if your
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2 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 1 8
Anesthesia Alert
Lee A. Fleisher, MD
• AWAKE AND ALERT Are you doing all you can to decrease elderly patients' risk for
developing memory loss after surgery?