Das postoperative Delir ist eine komplexe Störung, und es gibt kein Medikament, das
allein zur Delir-Behandlung geeignet wäre. In der Therapie stehen nichtpharmakologische
Maßnahmen im
Vordergrund – eine pharmakologische Behandlung kommt nur bei schwerwiegenden Symptomen
zum Einsatz; sie sollte zeitnah, symptomorientiert und niedrigdosiert erfolgen.
Abstract
Postoperative delirium (POD) is a complex disorder with significant implications for
health and well-being. Over the last few years, there has been a significant increase
in awareness of
the pathophysiological processes, the different clinical forms and the prevention
of POD. It is known that POD develops when anaesthetic- and surgery-related precipitating
factors coincide
with the patient’s predisposing vulnerability. Consequently, assessing the preoperative
physical, cognitive, psychological, social and resilience capabilities of patients
scheduled for
surgery is critical to assessing overall risk and determining optimal preoperative,
intraoperative and postoperative management, particularly as pharmacological treatment
options remain
limited. For treatment, non-pharmacological measures remain in the foreground, pharmacological
therapy is only used for severe symptoms, and should be symptom-oriented and low-dosed.
There
is no drug that is suitable for delirium treatment alone.
Schlüsselwörter
postoperatives Delir - POD - zentrales anticholinerges Syndrom - Angst - Schmerzen
- Sedierung
Keywords
postoperative delirium - central anticholinergic syndrome - anxiety - pain - sedation
