{"title":"术后谵妄和神经认知障碍：癌症患者护理人员的最新信息。","authors":"Donna Ron, Stacie Deiner","doi":"10.1007/s11912-024-01584-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide up to date information on postoperative delirium and neurocognitive disorders in surgical cancer patients.</p><p><strong>Recent findings: </strong>Established risk factors such as age, psychosocial factors, comorbidities, frailty and preexisting cognitive decline continue to exhibit associations with perioperative neurocognitive disorders (PND); novel risk factors identified recently include microbiome composition and vitamin D deficiency. Prevention measures include cognitive prehabilitation, perioperative geriatric assessment and multidisciplinary care, dexmedetomidine and multimodal analgesic techniques. Studies investigating ciprofol, remimazolam, esketamine, ramelteon and suvorexant have shown encouraging results. Controversy remains regarding the use of inhalational versus intravenous general anesthesia. Innovative approaches to address PND are a rapidly developing area of research, but more studies are needed to identify effective prevention and management interventions. Despite challenges and controversy in the field, implementation of best practice can reduce the detrimental impact of PND on patients, caregivers, and society at large.</p>","PeriodicalId":10861,"journal":{"name":"Current Oncology Reports","volume":null,"pages":null},"PeriodicalIF":4.7000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Postoperative Delirium and Neurocognitive Disorders: Updates for Providers Caring for Cancer Patients.\",\"authors\":\"Donna Ron, Stacie Deiner\",\"doi\":\"10.1007/s11912-024-01584-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose of review: </strong>To provide up to date information on postoperative delirium and neurocognitive disorders in surgical cancer patients.</p><p><strong>Recent findings: </strong>Established risk factors such as age, psychosocial factors, comorbidities, frailty and preexisting cognitive decline continue to exhibit associations with perioperative neurocognitive disorders (PND); novel risk factors identified recently include microbiome composition and vitamin D deficiency. Prevention measures include cognitive prehabilitation, perioperative geriatric assessment and multidisciplinary care, dexmedetomidine and multimodal analgesic techniques. Studies investigating ciprofol, remimazolam, esketamine, ramelteon and suvorexant have shown encouraging results. Controversy remains regarding the use of inhalational versus intravenous general anesthesia. Innovative approaches to address PND are a rapidly developing area of research, but more studies are needed to identify effective prevention and management interventions. Despite challenges and controversy in the field, implementation of best practice can reduce the detrimental impact of PND on patients, caregivers, and society at large.</p>\",\"PeriodicalId\":10861,\"journal\":{\"name\":\"Current Oncology Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Oncology Reports\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11912-024-01584-9\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Oncology Reports","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11912-024-01584-9","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/25 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
综述的目的：提供有关癌症手术患者术后谵妄和神经认知障碍的最新信息：年龄、社会心理因素、合并症、虚弱和原有认知功能下降等既定风险因素仍与围手术期神经认知障碍（PND）有关；最近发现的新风险因素包括微生物组构成和维生素 D 缺乏。预防措施包括认知预康复、围手术期老年评估和多学科护理、右美托咪定和多模式镇痛技术。对丙泊酚、雷米唑仑、艾司卡胺、雷美替康和苏伏雷康的研究结果令人鼓舞。在使用吸入式全身麻醉还是静脉注射式全身麻醉的问题上仍存在争议。解决 PND 的创新方法是一个快速发展的研究领域，但还需要更多的研究来确定有效的预防和管理干预措施。尽管该领域存在挑战和争议，但实施最佳实践可以减少 PND 对患者、护理人员和整个社会的不利影响。
Postoperative Delirium and Neurocognitive Disorders: Updates for Providers Caring for Cancer Patients.
Purpose of review: To provide up to date information on postoperative delirium and neurocognitive disorders in surgical cancer patients.
Recent findings: Established risk factors such as age, psychosocial factors, comorbidities, frailty and preexisting cognitive decline continue to exhibit associations with perioperative neurocognitive disorders (PND); novel risk factors identified recently include microbiome composition and vitamin D deficiency. Prevention measures include cognitive prehabilitation, perioperative geriatric assessment and multidisciplinary care, dexmedetomidine and multimodal analgesic techniques. Studies investigating ciprofol, remimazolam, esketamine, ramelteon and suvorexant have shown encouraging results. Controversy remains regarding the use of inhalational versus intravenous general anesthesia. Innovative approaches to address PND are a rapidly developing area of research, but more studies are needed to identify effective prevention and management interventions. Despite challenges and controversy in the field, implementation of best practice can reduce the detrimental impact of PND on patients, caregivers, and society at large.
期刊介绍：
This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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