title: Clinical observations of postoperative delirium after surgery for oral carcinoma.
abstract: The aim of the present study was to clarify the clinical characteristics of postoperative delirium and to determine appropriate postoperative management for its prevention. The authors analysed 132 cases of primary surgery for oral carcinoma and observed 24 (18%) cases of postoperative delirium. Univariate analysis revealed that significant risk factors for postoperative delirium were older age, male gender, extensive surgery and morphine pain control. Logistic regression analysis showed that older age and male gender were significant risk factors for postoperative delirium, while patient-controlled analgesia with fentanyl was effective for prevention of postoperative delirium. There was a trend for postoperative delirium to be associated with extensive surgery. In those who had delirium, blood tests revealed that alkaline phosphatase, total protein, sodium, chlorine, red blood cell count, haemoglobin and haematocrit were significantly diminished after surgery. These results indicate that general condition is closely related to the onset of postoperative delirium, and suggest that appropriate postoperative management can reduce the incidence of this complication.
authors.affiliation: Department of Dentistry and Oral Surgery, Chiba University Hospital, Chiba University, Chiba city, Chiba, Japan. m.shiiba@faculty.chiba-u.jp
authors.forename: M
authors.initials: M
authors.lastname: Shiiba
authors.forename: M
authors.initials: M
authors.lastname: Takei
authors.forename: M
authors.initials: M
authors.lastname: Nakatsuru
authors.forename: H
authors.initials: H
authors.lastname: Bukawa
authors.forename: H
authors.initials: H
authors.lastname: Yokoe
authors.forename: K
authors.initials: K
authors.lastname: Uzawa
authors.forename: H
authors.initials: H
authors.lastname: Tanzawa
mesh_terms: D000367:Age Factors; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003693:Delirium / Q000097:blood / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D009062:Mouth Neoplasms / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D011182:Postoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D005283:Fentanyl