%0 Journal Article
%T Does using a femoral nerve block for total knee replacement decrease postoperative delirium?
%A Sakura Kinjo
%A Eunjung Lim
%A Laura P Sands
%A Kevin J Bozic
%A Jacqueline M Leung
%J BMC Anesthesiology
%D 2012
%I BioMed Central
%R 10.1186/1471-2253-12-4
%X A prospective cohort study was conducted in patients who underwent total knee replacement. Baseline cognitive function was assessed using the Telephone Interview for Cognitive Status. Postoperative delirium was measured using the Confusion Assessment Method postoperatively. Incidence of postoperative delirium was compared in two postoperative management groups: femoral nerve block ¡À patient-controlled analgesia and patient-controlled analgesia only. In addition, pain levels (using numeric rating scales) and opioid use were compared in two groups.85 patients were studied. The overall incidence of postoperative delirium either on postoperative day one or day two was 48.1%. Incidence of postoperative delirium in the femoral nerve block group was lower than patient controlled analgesia only group (25% vs. 61%, P = 0.002). However, there was no significant difference between the groups with respect to postoperative pain level or the amount of intravenous opioid use.Femoral nerve block reduces the incidence of postoperative delirium. These results suggest that a larger randomized control trial is necessary to confirm these preliminary findings.Postoperative delirium is a common postoperative complication among older surgical patients, occurring in up to 60% of surgical patients after major surgery [1]. Postoperative delirium is associated with increased mortality and morbidity, greater medical expenses, prolonged hospital stays and poor functional status [2,3]. Although multiple risk factors for postoperative delirium have been proposed [2,4-7], the pathophysiology of postoperative delirium remains unclear. Previous work from our laboratory and the work from others suggest that postoperative pain is an important factor related to postoperative delirium [5,8]. However, the effects of postoperative pain management technique, especially the effects of peripheral nerve blocks on postoperative delirium, have not been investigated. Specifically, whether opioid-sparing technique
%U http://www.biomedcentral.com/1471-2253/12/4