title: Anesthetic Management of a Patient With Multiple Previous Episodes of Postanesthesia Care Unit Delirium: A Case Report.
abstract: We report the case of a 37-year-old female patient who required 22 surgeries following a pedestrian versus car accident. She was enrolled in a clinical study investigating emergence from anesthesia. In 10 of her 22 surgeries, we assessed her cognitive status in the postanesthesia care unit (PACU) using the Confusion Assessment Method. We observed PACU delirium in all 4 cases in which the patient received sevoflurane, but only in 1 of 6 cases in which she received propofol. The patient showed EEG α-band activity similar to that of an elderly patient who may reflect a greater risk of PACU delirium.
authors.affiliation: From the *Department of Anesthesiology, Emory University, Atlanta, Georgia; †Department of Anesthesiology & Perioperative Care, University of California, Irvine, California; and ‡Department of Anesthesiology, Atlanta VA Medical Center, Decatur, Georgia.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kreuzer
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Whalin
authors.forename: September D W
authors.initials: SDW
authors.lastname: Hesse
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Riso
authors.forename: Paul S
authors.initials: PS
authors.lastname: García
mesh_terms: D000328:Adult; D000513:Alpha Rhythm / Q000187:drug effects; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology; D019970:Cocaine-Related Disorders / Q000150:complications / Q000523:psychology; D003071:Cognition / Q000187:drug effects; D004569:Electroencephalography; D000071257:Emergence Delirium / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D002189:Marijuana Abuse / Q000150:complications / Q000523:psychology; D008385:Marijuana Smoking / Q000009:adverse effects / Q000523:psychology; D008738:Methyl Ethers / Q000009:adverse effects*; D015742:Propofol / Q000009:adverse effects*; D012307:Risk Factors; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol