Impact of consultation liaison services on postoperative psychotropic drug use

In clinical practice, most cases of postoperative delirium are treated by an attending surgeon who is not a specialist in delirium treatment. We investigated the postoperative use of psychotropic drugs with and without psychiatric consultation liaison service (CLS).

Patients who received specific psychotropic drugs postoperatively under general anesthesia were included. The participants were divided into two groups, with and without CLS intervention. The type and dosage of psychotropic drugs used, presence of delirium, and adverse drug events (ADEs) caused by psychotropic drugs administered postoperatively were investigated.

Of the 509 patients who were newly prescribed the psychotropic drugs postoperatively, 67 patients (13 %) received CLS intervention. In the non-CLS group, 65 % (43/66) of patients who received antipsychotics after surgery did not have delirium, which was significantly higher than in the CLS group (65 % vs 22 %, p < 0.01). Haloperidol was the most commonly used antipsychotic postoperatively, and the median daily dose was significantly higher in the non-CLS group (0.22 mg/day vs 0.38 mg/day, p = 0.04).

CLS interventions may contribute to a reduction in unnecessary administration of antipsychotic drugs and dosages.