• Ulf Guenther, Linda Riedel, and Finn M Radtke.
• aPD Dr med. Ulf Guenther DESA, EDIC, Linda Riedel, Klinik für Anästhesiologie & Operative Intensivmedizin, Universitätsklinikum Bonn, Bonn, Germany bPD Dr med. Finn M. Radtke, Anæstesiafdelingen, Næstved Sygehus, Næstved, Denmark.
• Curr Opin Anaesthesiol. 2016 Jun 1; 29 (3): 384-90.

Purpose Of ReviewThe aim of this study was to review current literature on identification of patients at risk for postoperative delirium (POD) and to summarize recent findings on prophylaxis and treatment.Recent FindingsAge and preoperative cognitive impairment are among the most important risk factors of POD. POD is the result of a complex interplay of predisposing and precipitating factors. Thus, both prophylaxis and treatment require multicomponent intervention programs. No single medication to prevent or treat POD is available. Avoiding too deep anesthesia, avoiding additional psychoactive substances including benzodiazepines and intravenous opioids, and effective pain management as well as early mobilization are essential.SummaryAn increase of the proportion of elderly patients undergoing surgery will lead to a higher incidence of POD. Preoperative assessment should facilitate identification of patients at high risk. Perioperative management should include monitoring depth of anesthesia, preference for nonopioid pain therapy, early regular delirium monitoring starting in the recovery room, avoiding ICU-sedation, early mobilization and exercise, and cognitive training.

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