Editorial| August 2021 The Cognitive Neuraxis: Epidurals and Postoperative Delirium Phillip E. Vlisides, M.D.; Phillip E. Vlisides, M.D. Search for other works by this author on: This Site PubMed Google Scholar George A. Mashour, M.D., Ph.D. George A. Mashour, M.D., Ph.D. Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information From the Department of Anesthesiology (P.E.V., G.A.M.), the Center for Consciousness Science (P.E.V., G.A.M.), and the Neuroscience Graduate Program (G.A.M.), University of Michigan Medical School, Ann Arbor, Michigan. This editorial accompanies the article on p. 218. This article has a related Infographic on p. A19. Accepted for publication April 16, 2021. Address correspondence to Dr. Mashour: gmashour@med.umich.edu Anesthesiology August 2021, Vol. 135, 197–199. https://doi.org/10.1097/ALN.0000000000003824 Connected Content Commentary: Delirium in Older Patients after Combined Epidural–General Anesthesia or General Anesthesia for Major Surgery: A Randomized Trial Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Phillip E. Vlisides, George A. Mashour; The Cognitive Neuraxis: Epidurals and Postoperative Delirium. Anesthesiology 2021; 135:197–199 doi: https://doi.org/10.1097/ALN.0000000000003824 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search nav search search input Search input auto suggest search filter All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: axon, postoperative delirium, delirium Delirium is a distressing syndrome that affects many surgical patients. Postoperative delirium is associated with falls, cognitive and functional decline, and prolonged hospitalization.1 Indeed, delirium is a major public health issue, and postoperative delirium serves as a target for surgical quality improvement.2 A promising strategy for reducing risk involves sustained interventions that simultaneously target multiple risk factors.3 Epidural analgesia is one such candidate intervention that has been demonstrated to reduce key delirium risk factors: pain, opioid consumption, and inflammation.4–6 Furthermore, epidural therapy can be continued over multiple days, particularly during time windows of peak delirium risk. Taken together, it seems plausible that such a sustained intervention, which simultaneously targets multiple risk factors, could reduce risk of postoperative delirium. As reported in this issue of Anesthesiology, Li et al. sought to determine whether combined general-epidural anesthesia, with continued postoperative epidural analgesia, would reduce the risk of... You do not currently have access to this content.
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