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Spinal block and delirium in oncologic patients after laparoscopic surgery in the Trendelenburg position: A randomized controlled trial.
Mitsunaga, Jorge Kiyoshi; Calsavara, Vinicius Fernando; Onari, Elton Shinji; Arantes, Vinicius Monteiro; Akamine, Carolina Paiva; Handa, Adriana Mayumi; Quezada, Michael Madeira de la Cruz; Ito, Franco Yasuhiro; Porto, Ana Carolina Souza; Giroud Joaquim, Eduardo Henrique; Nakamura, Giane.
Afiliação
  • Mitsunaga JK; Department of Anaesthesiology, A.C.Camargo Cancer Center, São Paulo, Brazil.
  • Calsavara VF; Department of Epidemiology and Statistics, A.C.Camargo Cancer Center, São Paulo, Brazil.
  • Onari ES; Department of Anaesthesiology, A.C.Camargo Cancer Center, São Paulo, Brazil.
  • Arantes VM; Department of Anaesthesiology, A.C.Camargo Cancer Center, São Paulo, Brazil.
  • Akamine CP; Department of Anaesthesiology, A.C.Camargo Cancer Center, São Paulo, Brazil.
  • Handa AM; Department of Anaesthesiology, A.C.Camargo Cancer Center, São Paulo, Brazil.
  • Quezada MMC; Department of Anaesthesiology, A.C.Camargo Cancer Center, São Paulo, Brazil.
  • Ito FY; Department of Anaesthesiology, A.C.Camargo Cancer Center, São Paulo, Brazil.
  • Porto ACS; Department of Cutaneous Oncology, A.C.Camargo Cancer Center, São Paulo, Brazil.
  • Giroud Joaquim EH; Department of Anaesthesiology, A.C.Camargo Cancer Center, São Paulo, Brazil.
  • Nakamura G; Department of Anaesthesiology, A.C.Camargo Cancer Center, São Paulo, Brazil.
PLoS One ; 16(5): e0249808, 2021.
Article em En | MEDLINE | ID: mdl-33999920
Delirium is the most common postsurgical neurological complication and has a variable incidence rate. Laparoscopic surgery, when associated with the Trendelenburg position, can cause innumerable physiological changes and increase the risk of neurocognitive changes. The association of general anesthesia with a spinal block allows the use of lower doses of anesthetic agents for anesthesia maintenance and facilitates better control over postoperative pain. Our primary outcome was to assess whether a spinal block influences the incidence of delirium in oncologic patients following laparoscopic surgery in the Trendelenburg position. Our secondary outcome was to analyze whether there were other associated factors. A total of 150 oncologic patients who underwent elective laparoscopic surgeries in the Trendelenburg position were included in this randomized controlled trial. The patients were randomized into 2 groups: the general anesthesia group and the general anesthesia plus spinal block group. Patients were immediately evaluated during the postoperative period and monitored until they were discharged, to rule out the presence of delirium. Delirium occurred in 29 patients in total (22.3%) (general anesthesia group: 30.8%; general anesthesia plus spinal block: 13.8% p = 0.035). Patients who received general anesthesia had a higher risk of delirium than patients who received general anesthesia associated with a spinal block (odds ratio = 3.4; 95% confidence interval: 1.2-9.6; p = 0.020). Spinal block was associated with reduced delirium incidence in oncologic patients who underwent elective laparoscopic surgeries in the Trendelenburg position.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Laparoscopia / Delírio / Neoplasias Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Laparoscopia / Delírio / Neoplasias Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos