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Related Experiment Video

Updated: May 18, 2026

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients

Published on: February 6, 2021

Delirium in the fast-track surgery setting.

Lene Krenk¹, Lars S Rasmussen, Henrik Kehlet

¹Rigshospitalet, Section of Surgical Pathophysiology, The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen O, Denmark. Lene.krenk@rh.regionh.dk

Best Practice & Research. Clinical Anaesthesiology

|October 9, 2012

Summary

Fast-track surgery may reduce postoperative cognitive decline. This perioperative care approach, especially after hip or knee replacement, showed no cases of postoperative delirium and over 50% less cognitive dysfunction in elderly patients.

Related Experiment Videos

Last Updated: May 18, 2026

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients

Published on: February 6, 2021

Area of Science:

Gerontology
Anesthesiology
Neurosurgery

Background:

Postoperative delirium (PD) and postoperative cognitive dysfunction (POCD) are significant concerns following major surgery, particularly in older adults.
The pathogenesis of these conditions is complex and multifactorial, necessitating a multimodal approach for risk reduction.
Fast-track methodology, a perioperative care strategy, shows promise in preventing cognitive decline.

Purpose of the Study:

To evaluate the impact of fast-track methodology on the incidence of postoperative delirium and cognitive dysfunction.
To assess the effectiveness of fast-track care in reducing cognitive decline after total hip/knee arthroplasty (THA/TKA) in elderly patients.

Main Methods:

A prospective study involving 225 patients aged 60 years and above undergoing THA/TKA.
Implementation of a fast-track perioperative care regime, emphasizing pain management, opioid reduction, early mobilization, and early discharge (≤3 days).
Comparison of PD and POCD incidence with historical data from previous studies.

Main Results:

No cases of postoperative delirium (PD) were observed in the study cohort.
A reduction of over 50% in the incidence of early postoperative cognitive dysfunction (POCD) was noted at one week postoperatively compared to previous studies.
The fast-track approach was associated with a lower frequency of PD and early POCD after THA/TKA.

Conclusions:

The fast-track methodology appears to be an effective strategy for reducing the incidence of postoperative cognitive decline after major orthopedic surgery.
This perioperative care model may mitigate the risks of both postoperative delirium and cognitive dysfunction in elderly patients undergoing THA/TKA.
Further research into optimizing fast-track protocols could enhance patient outcomes and reduce the burden of cognitive impairment post-surgery.