AN OBSERVATIONAL PROSPECTIVE ANALYSIS OF THE IMPACT OF POSTOPERATIVE PAIN AND ITS MANAGEMENT ON THE OCCURRENCE OF POSTOPERATIVE DELIRIUM: INSIGHTS FROM A STUDY CONDUCTED IN PALESTINE
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Date
2025-12-21
Authors
Elyyan, Mohammed Abdulrahim
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Publisher
جامعة النجاح الوطنية
Abstract
Introduction: Postoperative delirium is the sudden onset of fluctuating attention and disturbance of the usual mental state during the first seven days after surgery. How pain management influences the rate of postoperative delirium (POD) is an important consideration. This study was conducted to investigate the complexity of the relationship between the rates and characteristics of postoperative delirium and postoperative pain management.
Methods: This prospective cohort study used convenience sampling of 208 surgical patients at An-Najah National University Hospital and Rafidia Governmental Hospital in Nablus, Palestine. A data sheet was used as the data collection technique, and the data were collected from March 10 to September 10, 2024. The data sheet was divided into five sections: the Nursing Delirium Screening Scale (Nu-DESC), postoperative nausea and vomiting (PONV), assessment and management of postoperative pain, patient history and surgical characteristics, and sociodemographic information. SPSS was used to analyze the data while adhering strictly to ethical principles of confidentiality and anonymity
Results: The mean age of the patients was 47.11 ± 15.8 years. A total of 62.5% of the patients were males. Sixty-three percent of the patients were married. Most patients complained of POP (96%), PON occurred in 75% of patients, and POV occurred in 43.7% of patients. The incidence of POD was 29.8%. The POD is influenced by education level and smoking habits, and the P values are significant (0.04 and 0.045, respectively). The type of surgery was significantly associated with POD and POP (p values =0.037 and 0.044, respectively).
Additionally, our findings revealed a significant association between the occurrence of POD and surgical risk categories (p = 0.017). Furthermore, the use of rocuronium and isoflurane was significantly related to the development of POD, with p values of 0.042 and 0.03, respectively.
Conclusion: The incidence of POD in our study was 29.8%. The significantly associated factors included POV, isoflurane use, preoperative anxiolytics, and postoperative controlled analgesia and steroids. Recognition of these risk factors provides opportunities for preventive strategies and better perioperative care.
Keywords: POD, POP, PON, POV, Nursing Delirium Screening Scale (Nu-DESC), Rocuronium and isoflurane administration, Surgical patients, An-Najah National University Hospital, Rafidia Governmental Hospital, Nablus city, Palestine