Aktualisierte ESAIC-Leitlinie zum postoperativen Delir beim Erwachsenen

The updated ESAIC guideline on postoperative delirium (POD) comprises a total of 13 recommendations, including five with the recommendation grade “strong”: 1.) The assessment of preoperative POD risk factors, 2.) the optimisation of the preoperative condition, 3.) the discussion of prevention strategies, 4) the implementation of a non-pharmacological multicomponent intervention in patients at risk of POD and 5.) the risk-benefit assessment of the prophylactic administration of dexmedetomidine. The latter applies in particular due to the partly contradictory data situation and different areas of application (cardiac surgery versus non-cardiac surgery patients). Index-based EEG monitoring of the depth of anaesthesia is also recommended, whereby other parameters such as burst suppression and density spectral array should also be included. If non-pharmacological measures fail, POD should be treated with haloperidol. In contrast, the use of benzodiazepines is not recommended.