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Chapter 86 - Delayed Emergence, Change in Mental Status, Delirium, and Agitation

from Section 12 - Post-Anesthesia Care Unit

Published online by Cambridge University Press:  03 August 2023

By
Andrew Yurkonis  and
Jessica A. Lovich-Sapola
Edited by
Jessica A. Lovich-Sapola
Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
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Summary

A 67-year-old patient is in the post-anesthesia care unit (PACU) following a surgical repair of his left femur. He was found unconscious in the snow at a ski resort. He was awake prior to the induction of anesthesia. He denied any medical or surgical history. His toxicology screen was still pending. You are called to the PACU to see the patient because he is unarousable. What is your differential diagnosis? How will you treat this?

Type
Chapter
Information
Anesthesia Oral Board Review
Knocking Out The Boards
 , pp. 365 - 367
Publisher: Cambridge University Press
Print publication year: 2023

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References

Barash, PG, Cullen, BF, Stoelting, RK, et al. Clinical Anesthesia, 8th ed. Philadelphia: Lippincott Williams & Wilkins, 2017, pp. 1557–8.Google Scholar
Fleisher, LA, Rosenbaum, SH. Complications in Anesthesia, 3rd ed. Philadelphia: Elsevier, 2018, pp. 535–538.Google ScholarPubMed
Ford, MD, Delaney, KA, Ling, LJ, et al. Clinical Toxicology, 1st ed. Philadelphia: WB Saunders Company, 2001, chapter 56.Google Scholar
Gropper, M. Miller’s Anesthesia, 9th edition. Philadelphia: Elsevier, 2020, pp. 2604–6.Google Scholar
Janssen, TL, Alberts, AR, Hooft, L, et al. Prevention of postoperative delirium in elderly patients planned for elective surgery: systematic review and metanalysis. Clin Interv Aging 2019;14:1095–117.CrossRefGoogle Scholar
McGee, MD. Evidenced Based Physical Diagnosis, 5th ed. Philadelphia: Elsevier, 2022, pp. 143–53.Google Scholar

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