The Impact of the Type of Anesthesia to the Occurrence of Postoperative Delirium in Elderly Patients

Postoperative delirium is defined as an acute change in the mental condition resulting to an impairment of cognitive functions (orientation, memory and organizational capabilities) inability to maintain concentration and attention problems in perception and changes in the cycle of sleep and wakefulness. The etiology is multifactorial and depends on the clinical features of frequency of the patient, the type of surgery and anesthesia. The purpose of this paper is to show whether there is a difference in the occurrence of postoperative delirium, depending on the type of anesthesia in the first 48 hours at the patients who are over 60 years. Method The prosperous pilot study is performed on 30 patients aged over 60 years in the period of 3 months. What all patients will be observed is the general health status, the degree of the risk of interventions is determined (ASA status), age, type of anesthesia and the type of operation, as well as the level of education. For the evaluation of the mental status the psychological test Bomke is used (Blesedov test for orientation, memory and concentration). Results A comparison is being made to the results of the physical and mental health of patients receiving the results of the assessment of the mental status on the day of the surgery and the second day i. e.48 hours after the surgery. The results suggest that changes in mental status occur in 5 patients of which 3 in the MEA (endotracheal general anesthesia) and 2 RA (regional anesthesia), but the difference is not statistically significant. Conclusion The occurrence of postoperative delirium depends on the health condition of the patient and the type of surgical treatment and anesthesia. Adult patients are most affected by this complication so you need to carefully evaluate the mental and neurological status because of adequate assessment of the risks and benefits of the planned surgical intervention. The study shows that postoperative delirium occurs less in regional anesthesia then general, but the difference is not statistically significant. It requires a multidisciplinary approach in solving this problem which requires the participation of an anesthesiologist, surgeon, neuropsychiatrist and other experts.