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- W2491014762 abstract "Editor—We thank Al-Hindawi and colleagues for their interest in our work1Hirsch J DePalma G Tsai TT Sands LP Leung JM Impact of intraoperative hypotension and blood pressure fluctuations on early postoperative delirium after non-cardiac surgery.Br J Anaesth. 2015; 115: 418-426Abstract Full Text Full Text PDF PubMed Scopus (144) Google Scholar and insightful comments. As they stated correctly, screening for preoperative cognitive decline did not influence the inclusion or exclusion of patients in the study. The purpose of the screening was to determine the baseline cognitive status of the patient, because cognitive impairment is a major predictor for postoperative delirium. We agree that our patient population was fairly heterogeneous and representative of the real-world sample. Focusing a priori on one type of surgical patient would have limited the generalizability of the study and would have reduced the sample size that could be achieved in a given time period. Moreover, it would have precluded comparisons between populations. As stated in our paper, we found a significant difference in the incidence of delirium between different types of surgeries, with the highest percentage of patients with delirium in the orthopaedic surgery group. The type of general anaesthesia that was used universally in our study was a balanced anaesthesia technique, using a combination of i.v. and volatile agents. Our prior work and work from others did not show that the types of anaesthetics contribute to the incidence of delirium. Whether future studies will show a relationship (as the PINOCCHIO trial mentioned by you) between different types of anaesthetics on postoperative delirium remains to be determined. The influence of postoperative analgesia was not part of this study. Our group has, however, published earlier work 2Fong HK Sands LP Leung JM The role of postoperative analgesia in delirium and cognitive decline in elderly patients: a systematic review.Anesth Analg. 2006; 102: 1255-1266Crossref PubMed Scopus (260) Google Scholar, 3Wang Y Sands LP Vaurio L Mullen EA Leung JM The effects of postoperative pain and its management on postoperative cognitive dysfunction.Am J Geriatr Psychiatry. 2007; 15: 50-59Abstract Full Text Full Text PDF PubMed Scopus (106) Google Scholar to elucidate this question. None declared." @default.
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- W2491014762 date "2016-08-01" @default.
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- W2491014762 title "Reply: heterogeneous population" @default.
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- W2491014762 doi "https://doi.org/10.1093/bja/aew198" @default.
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