FREQUENCY OF POST-OPERATIVE DELIRIUM OBSERVED IN POST-OPERATIVE ANESTHESIA CARE UNIT DURING EMERGENCE OF PATIENTS FROM GENERAL ANESTHESIA

Abstract

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Background: Postoperative delirium (POD) is an acute neurocognitive disturbance that commonly occurs during recovery from general anesthesia and is traditionally associated with older age. However, younger adults may also be vulnerable due to perioperative physiological stress, anesthetic exposure, and surgical complexity. Early identification of POD in the Post-Anesthesia Care Unit (PACU) is essential, as undetected delirium is linked to prolonged recovery, postoperative complications, and increased healthcare utilization. Despite this, data on POD during emergence in younger adult populations remain limited.

Objective: To determine the incidence of postoperative delirium during the emergence phase from general anesthesia among adults aged 18–55 years and to evaluate its association with selected perioperative factors.

Methods: A descriptive cross-sectional study was conducted in the PACU involving 120 adult patients undergoing elective or emergency surgery under general anesthesia. Delirium assessment was performed within 10–15 minutes of extubation using validated screening tools, including the Richmond Agitation-Sedation Scale (RASS), 4 A’s Test (4AT), 3-Minute Diagnostic Confusion Assessment Method (3D-CAM), and the Nursing Delirium Screening Scale (Nu-DESC). Demographic variables, American Society of Anesthesiologists (ASA) physical status, type of surgery, and anesthesia-related characteristics were recorded. Statistical analysis was performed using SPSS, with chi-square testing applied to assess associations between POD and relevant variables.

Results: Postoperative delirium was identified in 11 out of 120 patients, yielding an incidence of 9.2% during the emergence phase. Delirium occurrence increased significantly with advancing age within the study range, with the highest frequency observed in patients aged 50–55 years (p = 0.001). A greater proportion of delirium cases occurred in patients classified as ASA III compared with ASA I and ASA II. Male patients accounted for a higher number of delirium cases, although gender was not statistically associated with POD. Delirium was disproportionately more frequent following cardiac and other high-risk surgeries compared with lower-risk procedures.

Conclusion: Postoperative delirium occurs in a meaningful proportion of younger adults during emergence from general anesthesia. Routine delirium screening in the PACU using validated tools should be incorporated into standard perioperative care, particularly for patients undergoing high-risk procedures, to support early recognition and improved postoperative outcomes.