Clinical Observations of Postoperative Delirium after Surgery for Oral Carcinoma

Objectives: Postoperative delirium frequently causes various management problems for postoperative patients. The aim of the present study was to clarify the clinical characteristics of postoperative delirium and to determine appropriate postoperative management for its prevention.

Methods: A total of 132 cases of primary surgery for oral carcinoma were analyzed, and the incidence and clinical characteristics were investigated.

Results: We observed 24 (18.2%) cases of postoperative delirium. Univariate analysis revealed that older age (p=0.0023), male gender (p=0.0237), extensive surgery (p=0.0384) and morphine pain control (p=0.0025) were significant risk factors for postoperative delirium. Older age, male gender and morphine pain control were also found to be significant risk factors on stepwise regression analysis; furthermore, logistic regression analysis showed that older age (OR 1.097, 95%CI 1.037-1.159) and male gender (OR 5.486, 95%CI 1.582-19.017) were significant risk factors for postoperative delirium, while pain control with fentanyl-PCA was protective against delirium (OR 0.220, 95%CI 0.070-0.694). In addition, there was a trend for postoperative delirium to be associated with extensive surgery.

Conclusion: The present study strongly suggests that surgeons should pay adequate attention to the clinical characteristics of postoperative delirium and that appropriate postoperative management can reduce the incidence of postoperative delirium.