In geriatric patients, does opioid pain management increase postoperative delirium?

Disciplines

Nursing

Abstract (300 words maximum)

Background:

Delirium is an acute brain dysfunction that results in fluctuations of cognitive symptoms. In the geriatric population, people 60 years and older, the incidence of postoperative delirium is notably higher than in younger patients. In addition, delirium after surgery is also seen frequently in older patients.

Purpose:

The purpose of this literature review was to determine if the use of opioids for pain management contributes to higher incidences of postoperative delirium in geriatric patients.

Methods:

We performed a systematic literature review guided by the John Hopkins Evidence-Based Practice Model. The databases used were CINAHL, EBSCOhost, and PubMed. The key words we searched were geriatrics, opioids, postoperative delirium, pain management, elderly patients, and incidence of delirium. Only research literature from the last five years were retrieved. Other inclusion criteria included peer-reviewed articles, age of 60 and older, pharmacological interventions, and postoperative patients. The PRISMA diagram will reflect the screening process results. The final twenty articles were appraised for quality, evidence level, and relative evidence to our guiding clinical question.

Results:

Initially, the search resulted in 2390 articles. After filtering through duplicates and applying the exclusion criteria, 20 articles were selected for review of evidence. Preliminary results suggest a higher incidence of postoperative delirium when pain is managed with opioids.

Conclusion:

Final analysis with discussion and implications will be shared at the Symposium.

Academic department under which the project should be listed

WCHHS - Nursing

Primary Investigator (PI) Name

Doreen Wagner

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In geriatric patients, does opioid pain management increase postoperative delirium?

Background:

Delirium is an acute brain dysfunction that results in fluctuations of cognitive symptoms. In the geriatric population, people 60 years and older, the incidence of postoperative delirium is notably higher than in younger patients. In addition, delirium after surgery is also seen frequently in older patients.

Purpose:

The purpose of this literature review was to determine if the use of opioids for pain management contributes to higher incidences of postoperative delirium in geriatric patients.

Methods:

We performed a systematic literature review guided by the John Hopkins Evidence-Based Practice Model. The databases used were CINAHL, EBSCOhost, and PubMed. The key words we searched were geriatrics, opioids, postoperative delirium, pain management, elderly patients, and incidence of delirium. Only research literature from the last five years were retrieved. Other inclusion criteria included peer-reviewed articles, age of 60 and older, pharmacological interventions, and postoperative patients. The PRISMA diagram will reflect the screening process results. The final twenty articles were appraised for quality, evidence level, and relative evidence to our guiding clinical question.

Results:

Initially, the search resulted in 2390 articles. After filtering through duplicates and applying the exclusion criteria, 20 articles were selected for review of evidence. Preliminary results suggest a higher incidence of postoperative delirium when pain is managed with opioids.

Conclusion:

Final analysis with discussion and implications will be shared at the Symposium.

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