Effects of an opioid-free care pathway vs. opioid-based standard care on postoperative pain and postoperative quality of recovery after laparoscopic bariatric surgery

Adelaars S, et al.

Journal of Clinical Anesthesia. 2025. https://doi.org/10.1016/j.jclinane.2025.111896

This prospective cohort study evaluated 50 elderly patients undergoing aortic valve replacement to compare delirium detection rates using three methods: clinical observation, the Delirium Observation Screening (DOS) scale, and single-lead EEG (sl-EEG). The incidence of postoperative delirium varied significantly—32% with clinical observation, 28% with DOS, and 76% with sl-EEG. Clinical observation and DOS showed 80% concordance, while sl-EEG captured significantly more cases (p < 0.001), suggesting higher sensitivity but potential for false positives. Delirium rates declined over the 7-day postoperative period across all methods. The findings highlight the limitations of using any single diagnostic tool and suggest that a combined diagnostic strategy may provide a more accurate assessment of delirium, especially in hypoactive presentations.

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We thank the Journal of Clinical Anesthesia for publishing this important study. Their ongoing contributions to evidence-based perioperative research enhance clinical awareness and promote better outcomes in anesthesiology.