Pharmacological Management of Postoperative Delirium

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.