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    The Effect of Patient-controlled Intravenous Analgesia (PCIA) on Postoperative Delirium in Patients with Liver Transplantation: a Propensity Score Matching Analysis

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    https://www.riss.kr/link?id=A107770777

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    Objectives: Postoperative opioid use and pain are related to postoperative delirium. This study aims to compare the incidence of delirium in patients with and without patient-controlled intravenous analgesia (PCIA) among liver transplant recipients.
    Methods: The medical records of 253 patients who received liver transplantation (LT) from January 2010 to July 2017 in a single university hospital were retrospectively reviewed. Patients were divided into two groups: the patients who had used PCIA (P group, n = 71) and those who did not use PCIA (C group, n = 182) after LT in intensive care unit (ICU). The patient data were collected, which included demographic data, and details about perioperative management and postoperative complications.
    Results: There was no difference in the model for end-stage liver disease (MELD) score between the two groups. Postoperative delirium occurred in 10 / 71 (14.08 %) in the P group and 26 / 182 (14.29 %) in the C group after LT, respectively (P = 0.97). After propensity score matching, no differences were observed in the incidence of delirium (P = 0.359) and the time from surgery to discharge (P = 0.26) between the two groups.
    Conclusions: Patients with PCIA after LT exhibited no relationship with postoperative delirium. Therefore, it is necessary to actively control postoperative pain using PCIA.
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    Objectives: Postoperative opioid use and pain are related to postoperative delirium. This study aims to compare the incidence of delirium in patients with and without patient-controlled intravenous analgesia (PCIA) among liver transplant recipients. M...

    Objectives: Postoperative opioid use and pain are related to postoperative delirium. This study aims to compare the incidence of delirium in patients with and without patient-controlled intravenous analgesia (PCIA) among liver transplant recipients.
    Methods: The medical records of 253 patients who received liver transplantation (LT) from January 2010 to July 2017 in a single university hospital were retrospectively reviewed. Patients were divided into two groups: the patients who had used PCIA (P group, n = 71) and those who did not use PCIA (C group, n = 182) after LT in intensive care unit (ICU). The patient data were collected, which included demographic data, and details about perioperative management and postoperative complications.
    Results: There was no difference in the model for end-stage liver disease (MELD) score between the two groups. Postoperative delirium occurred in 10 / 71 (14.08 %) in the P group and 26 / 182 (14.29 %) in the C group after LT, respectively (P = 0.97). After propensity score matching, no differences were observed in the incidence of delirium (P = 0.359) and the time from surgery to discharge (P = 0.26) between the two groups.
    Conclusions: Patients with PCIA after LT exhibited no relationship with postoperative delirium. Therefore, it is necessary to actively control postoperative pain using PCIA.

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    참고문헌 (Reference)

    1 윤진선, "간이식 수술 후 발생한 술 후 섬망의 위험 인자에 대한 고찰" 대한마취통증의학회 57 (57): 584-589, 2009

    2 Fong HK, "The role of postoperative analgesia in delirium and cognitive decline in elderly patients : a systematic review" 102 : 1255-1266, 2006

    3 Wang Y, "The effects of postoperative pain and its management on postoperative cognitive dysfunction" 15 : 50-59, 2007

    4 Lee H, "Risk Factors of Postoperative Delirium in the Intensive Care Unit After Liver Transplantation" 42 : 2992-2999, 2018

    5 Chiu NM, "Psychiatric consultation for post-liver-transplantation patients" 63 : 471-477, 2009

    6 Lescot T, "Postoperative delirium in the intensive care unit predicts worse outcomes in liver transplant recipients" 27 : 207-212, 2013

    7 Vaurio LE, "Postoperative delirium : the importance of pain and pain management" 102 : 1267-1273, 2006

    8 Mueller AR, "Perioperative factors influencing patient outcome after liver transplantation" 13 (13): S158-161, 2000

    9 Rompianesi G, "Neurological complications after liver transplantation as a consequence of immunosuppression : univariate and multivariate analysis of risk factors" 28 : 864-869, 2015

    10 Lewis MB, "Neurologic complications of liver transplantation in adults" 61 : 1174-1178, 2003

    1 윤진선, "간이식 수술 후 발생한 술 후 섬망의 위험 인자에 대한 고찰" 대한마취통증의학회 57 (57): 584-589, 2009

    2 Fong HK, "The role of postoperative analgesia in delirium and cognitive decline in elderly patients : a systematic review" 102 : 1255-1266, 2006

    3 Wang Y, "The effects of postoperative pain and its management on postoperative cognitive dysfunction" 15 : 50-59, 2007

    4 Lee H, "Risk Factors of Postoperative Delirium in the Intensive Care Unit After Liver Transplantation" 42 : 2992-2999, 2018

    5 Chiu NM, "Psychiatric consultation for post-liver-transplantation patients" 63 : 471-477, 2009

    6 Lescot T, "Postoperative delirium in the intensive care unit predicts worse outcomes in liver transplant recipients" 27 : 207-212, 2013

    7 Vaurio LE, "Postoperative delirium : the importance of pain and pain management" 102 : 1267-1273, 2006

    8 Mueller AR, "Perioperative factors influencing patient outcome after liver transplantation" 13 (13): S158-161, 2000

    9 Rompianesi G, "Neurological complications after liver transplantation as a consequence of immunosuppression : univariate and multivariate analysis of risk factors" 28 : 864-869, 2015

    10 Lewis MB, "Neurologic complications of liver transplantation in adults" 61 : 1174-1178, 2003

    11 Pandharipande PP, "Long-term cognitive impairment after critical illness" 369 : 1306-1316, 2013

    12 Clegg A, "Interventions for preventing delirium in older people in institutional long-term care" CD 009537-, 2014

    13 Piñero F, "Incidence, risk factors, and outcomes related with neurological events after liver transplantation in adult and pediatric recipients" 22 : e13159-, 2018

    14 Haugen CE, "Incidence, Risk Factors, and Sequelae of Postkidney Transplant Delirium" 29 : 1752-1759, 2018

    15 Balderramo D, "Hepatic encephalopathy and post-transplant hyponatremia predict early calcineurin inhibitor-induced neurotoxicity after liver transplantation" 24 : 812-819, 2011

    16 Leung JM, "Does postoperative delirium limit the use of patient-controlled analgesia in older surgical patients?" 111 : 625-631, 2009

    17 최준권, "Delirium in the intensive care unit" 대한마취통증의학회 65 (65): 195-202, 2013

    18 Boettger S, "Delirium in the intensive care setting : A reevaluation of the validity of the CAM-ICU and ICDSC versus the DSM-IV-TR in determining a diagnosis of delirium as part of the daily clinical routine" 15 : 675-683, 2017

    19 Tilouche N, "Delirium in the Intensive Care Unit : Incidence, Risk Factors, and Impact on Outcome" 22 : 144-149, 2018

    20 Jackson JC, "Cognitive impairment after critical illness : etiologies, risk factors, and future directions" 34 : 216-222, 2013

    21 Vizzini G, "Changing picture of central nervous system complications in liver transplant recipients" 17 : 1279-1285, 2011

    22 Mody K, "Benzodiazepines and Development of Delirium in Critically Ill Children : Estimating the Causal Effect" 46 : 1486-1491, 2018

    23 Pisani MA, "Benzodiazepine and opioid use and the duration of intensive care unit delirium in an older population" 37 : 177-183, 2009

    24 Belcher JM, "Association of AKI with mortality and complications in hospitalized patients with cirrhosis" 57 : 753-762, 2013

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    기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
    2016 0.02 0.02 0.03
    KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
    0.04 0.04 0.21 0
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