Dexmedetomidine Use for Reduction in Postoperative Delirium in Geriatric Surgical Populations

Abstract

Purpose: Determine the effectiveness of an educational session on provider knowledge and attitude toward use of dexmedetomidine perioperatively for the reduction in the incidence of postoperative delirium (POD) in the geriatric surgical patient population.Background: Over 230 million surgical procedures are performed each year globally; the geriatric population is projected to reach 1.6 billion by the year 2050; and the geriatric patient population receives over one-third of all anesthetics delivered each year. Postoperative delirium is an unfortunate complication of surgery in geriatric patients, and evidence suggests dexmedetomidine use perioperatively can reduce the risk of postoperative delirium in this population. Methods: Presented an educational session to anesthesia providers on the use of dexmedetomidine to reduce the incidence of postoperative delirium in the geriatric surgical patient population to improve provider knowledge and use of dexmedetomidine perioperatively. The outcome measures included the percentage of anesthesia providers who report favorable attitudes towards use of dexmedetomidine in the geriatric surgical population, and the percentage of providers that indicate improved knowledge of the use of dexmedetomidine for POD in the geriatric surgical population. Results: Pre-intervention survey demonstrated a need for educational session on dexmedetomidine as only 25% of the participants felt there was a strong correlation between use of dexmedetomidine and reduction of POD. This number increased to 78% following the presentation. Provider knowledge of identification of the correct type of medication that research suggests reduces the risk of POD in geriatric patients increased from 50% to 80%, and identification of how dexmedetomidine affects POD improved from 27% to 100% immediately after the presentation, with a 30% loss of retention of knowledge in the 30-day post-intervention survey. Conclusions: Anesthesia providers increased their knowledge, attitudes, and use of dexmedetomidine for reduction in POD in the geriatric surgical population after the educational presentation.