Perioperative physiotherapy under epidural analgesia prevents postoperative delirium in elective upper abdominal surgery
上部開腹手術における術後譫妄抑止に対する硬膜外鎮痛下理学療法の有効性

Kouta Yamauchi, Hiroshi Ishimura, Hirofumi Shimazoe, Hitoshi Ayabe, Youko Takahashi, Yasuo Kaizuka, Hidefumi Higashi
2011 Journal of the Japanese Society of Intensive Care Medicine  
Objectives: Delirium is frequently observed in elderly patients after upper abdominal surgery. The purpose of the present study was to examine whether perioperative physiotherapy prevented and improved postoperative delirium in elective upper abdominal surgery patients. Methods: A total of 338 patients who underwent elective upper abdominal surgery were examined between 2002 and 2009. The subjects included 202 patients who underwent perioperative physiotherapy (intervention group) and 136
more » ... ts who did not undergo perioperative physiotherapy (control group). One examined factor was whether or not the incidence of postoperative delirium, the onset of delirium from surgery, and the duration of delirium were all clearly reported in the clinical records. Results: The incidence of postoperative delirium in the intervention group (7.9%) was significantly lower than that in the control group (25.7%) (P<0.001). The onset of delirium from surgery occurred at a significantly earlier time in the intervention group in comparison to the control group (P = 0.019). The duration of delirium in the intervention group (1.1 ± 0.4 days) was significantly shorter than that in the control group (2.1 ± 1.5 days) (P < 0.001). In the multiple logistic regression model, perioperative physiotherapy [odds ratio (OR) 0.20, 95% confidence interval (CI) 0.10 to 0.39, P < 0.001] , age (OR 1.09, 95%CI 1.05 to 1.14, P < 0.001) and cerebrovascular disease (OR 3.52, 95%CI 1.43 to 8.70, P = 0.006) were independent risk factors of postoperative delirium. Conclusions: Our findings suggest that peri operative physiotherapy reduces the incidence of delirium and prevents prolongation of such delirium.
doi:10.3918/jsicm.18.599 fatcat:ncojoaa63rf5vnsqvqcqkn77b4