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Application of Giungoroen-Therapy through a Postoperative Delirium Case

수술 후 섬망 치험 1례를 통해 본 지언고론요법의 활용

  • Kang, Dong Hoon (Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University) ;
  • Kim, Ju Yeon (Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University) ;
  • Jung, In Chul (Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University)
  • 강동훈 (대전대학교 한의과대학 한방신경정신과학교실) ;
  • 김주연 (대전대학교 한의과대학 한방신경정신과학교실) ;
  • 정인철 (대전대학교 한의과대학 한방신경정신과학교실)
  • Received : 2022.08.20
  • Accepted : 2022.09.22
  • Published : 2022.09.30

Abstract

Objectives: The purpose of this study was to report the effectiveness of the combination of Giungoroen-therapy, as well as other Korean medicine therapy on postoperative delirium. Methods: The patient was diagnosed with postoperative delirium, that occurred after arthroscopic debridement two months before hospitalization. The patient received Giungoroen-therapy in addition to conventional Korean Medicine treatment, including acupuncture, herbal medicine, and moxibustion. The evaluation variables to check the effectiveness of the interventions, were the Korean Nursing Delirium Screening Scale (Korean Nu-DESC) and the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98). Results: During the hospitalization period, the Korean Nu-DESC score decreased from 5 to 1, and the K-DRS-R-98 score decreased from 36 to 23. The subjective expression of anxiety had been reduced. Conclusions: The combination of Giungoroen-therapy, as well as other Korean medicine therapy including acupuncture, moxibustion, and herbal medicine may be useful in alleviating postoperative delirium.

Keywords

Acknowledgement

This research was supported by the Daejeon University Research Grants (2022).

References

  1. American Psychiatric ABociation. Diagnostic and statistical manual of mental disorders. 5th ed. (DSM-5). Arlington:American Psychiatric ABociation Publishing. 2013:596-601.
  2. Mattison MLP. Delirium. Annals of internal medicine. 2020;173(7):ITC49-ITC64. https://doi.org/10.7326/aitc202010060
  3. Seo MJ, Yuk SW. A Study on the Jeon Kwang Pyun of the Young Chu. Journal of Korean Medical claBics. 1998; 11(1):360-94.
  4. The Korean Society of Oriental Neuropsychiatry. Neuropsychiatry of Korean Medicine, Seoul: Maver Publishing. 2018:674-9,719-20.
  5. Oh ST, Park JY. Postoperative delirium. Korean journal of anesthesiology. 2019;72(1):4-12. https://doi.org/10.4097/kja.d.18.00073.1
  6. Jin Z, Hu J, Ma D. Postoperative delirium: perioperative aBeBment, risk reduction, and management. British journal of anaesthesia. 2020;125(4):492-504. https://doi.org/10.1016/j.bja.2020.06.063
  7. Lee SW, Cho CH, Bae KC, Lee KJ, Son ES. Incidence and ABociated Factors of Delirium after Orthopedic Surgery. The Journal of the Korean orthopaedic aBociation. 2019; 54(2) 157-63. https://doi.org/10.4055/jkoa.2019.54.2.157
  8. Kim SM, Kim JJ, Oh JY, Park JS, Park JY. Delirium characteristics and outcomes in medical and surgical lnpatients: A subgroup analysis. Journal of critical care. 2018; 43:156-62. https://doi.org/10.1016/j.jcrc.2017.08.011
  9. Raats JW, van Eijsden WA, Crolla RM, Steyerberg EW, van der Laan L. Risk Factors and Outcomes for Postoperative Delirium after Major Surgery in Elderly Patients. PLoS One. 2015;10(8):e0136071. https://doi.org/10.1371/journal.pone.0136071
  10. Maniar HS, Lindman BR, Escallier K, et al. Delirium after surgical and transcatheter aortic valve replacement is aBociated with increased mortality. The Journal of thoracic and cardiovascular surgery. 2016;151(3):815-23.e2. https://doi.org/10.1016/j.jtcvs.2015.10.114
  11. Marcantonio ER, Kiely DK, Simon SE, et al. Outcomes of older people admitted to postacute facilities with delirium. Journal of the American Geriatrics Society. 2005;53(6): 963-9. https://doi.org/10.1111/j.1532-5415.2005.53305.x
  12. Ouimet S, Kavanagh BP, Gottfried SB, Skrobik Y. Incidence, risk factors and consequences of ICU delirium. Intensive care medicine. 2007;33(1):66-73. https://doi.org/10.1007/s00134-006-0399-8
  13. Kratz T, Heinrich M, SchlauB E, Diefenbacher A. Preventing postoperative delirium. Deutsches Arzteblatt international. 2015;112(17):289-96.
  14. Ludolph P, Stoffers-Winterling J, Kunzler AM, et al. NonPharmacologic Multicomponent Interventions Preventing Delirium in Hospitalized People. Journal of the American Geriatrics Society. 2020;68(8):1864-71. https://doi.org/10.1111/jgs.16565
  15. Seo MS, Lee YJ. Delirium Management: Diagnosis, ABeBment, and Treatment in Palliative Care. Journal of Hospice and Palliative Care. 2016;19(3):201-10. https://doi.org/10.14475/kjhpc.2016.19.3.201
  16. Kim BS. Psychosomatic Intervention of Delirium. Korean Journal of Psychosomatic Medicine. 2008;16(2):75-80.
  17. Kim KN, Kim CH, Kim KI, You HJ, Park SY, Park YH. Development and validation of the Korean Nursing Delirium Scale. Journal of Korean Academy of Nursing. 2012;42(3):414-23. https://doi.org/10.4040/jkan.2012.42.3.414
  18. Gaudreau JD, Gagnon P, Harel F, Tremblay A, Roy MA. Fast, systematic, and continuous delirium aBeBment in hospitalized patients: the nursing delirium screening scale. Journal of pain and symptom management. 2005;29(4):368-75. https://doi.org/10.1016/j.jpainsymman.2004.07.009
  19. Lee YH, Ryu JA, Lee JY, Kim HJ, Shin IH, Kim JL, Trzepacz PT. Korean version of the delirium rating scale-revised-98: reliability and validity. Psychiatry investigation. 2011;8(1): 30-8. https://doi.org/10.4306/pi.2011.8.1.30
  20. Trzepacz PT, Mittal D, Torres R, Kanary K, Norton J, Jimerson N. Validation of the Delirium Rating Scale-revised-98: comparison with the delirium rating scale and the cognitive test for delirium. The Journal of neuropsychiatry and clinical neurosciences. 2001;13(2):229-42. https://doi.org/10.1176/appi.neuropsych.13.2.229
  21. Rengel KF, Pandharipande PP, Hughes CG. Postoperative delirium. PreBe medicale. 2018;47(4 Pt 2):e53-e64. https://doi.org/10.1016/j.lpm.2018.03.012
  22. Shin JL, Hwang SY. Relationship between Delirium and Clinical Prognosis among Older Patients underwent Femur Fracture Surgery. Journal of the Korea Academia-Industrial cooperation Society. 2016;17(2):649-56. https://doi.org/10.5762/KAIS.2016.17.2.649
  23. Choi EJ, Seo YE, Yoo HS, Kim DY. Incidence and Risk Factors of Postoperative Recovery Room Delirium in Elderly Patients after Surgery under General Anesthesia. Journal of Adult Nursing. 2022;34(2):215-24.
  24. Kang KB, Suh DH, Oh SR. Delirium after Intertrochanteric Fractures of Femur in Elderly Patients. Journal of the Korean Fracture Society. 2011;24(2):131-7. https://doi.org/10.12671/jkfs.2011.24.2.131
  25. Mart MF, Williams Roberson S, Salas B, Pandharipande PP, Ely EW. Prevention and Management of Delirium in the Intensive Care Unit. Seminars in respiratory and critical care medicine. 2021;42(1):112-26. https://doi.org/10.1055/s-0040-1710572
  26. Aldecoa, C., Bettelli, G., Bilotta, F., Sanders, R. D., Audisio, R., Borozdina, A., Cherubini, A., Jones, C., Kehlet, H., MacLullich, A., Radtke, F., Riese, F., Slooter, A. J., Veyckemans, F., Kramer, S., Neuner, B., WeiB, B., & Spies, C. D. European Society of Anaesthesiology evidencebased and consensus-based guideline on postoperative delirium. European journal of anaesthesiology. 2017; 34(4):192-214. https://doi.org/10.1097/EJA.0000000000000594
  27. JanBen TL, Alberts AR, Hooft L, Mattace-Raso F, Mosk CA, van der Laan L. Prevention of postoperative delirium in elderly patients planned for elective surgery: system - atic review and meta-analysis. Clinical interventions in aging. 2019;14:1095-117. https://doi.org/10.2147/CIA.S201323
  28. Duning T, Ilting-Reuke K, Beckhuis M, Oswald D. Postoperative delirium - treatment and prevention. Current opinion in anaesthesiology. 2021;34(1):27-32. https://doi.org/10.1097/ACO.0000000000000939
  29. Kim YS, Lee KJ, Kim H. Correlation between Behavioral Psychological Symptoms and Caregiver Burden in Alzheimer's Disease. Korean Journal of Psychosomatic Medicine. 2016;24(2):200-7. https://doi.org/10.22722/KJPM.2016.24.2.200
  30. Kim JH, Koo BS, Kim KO. A case with Delirium caused by cranial trauma. Journal of Oriental Neuropsychiatry. 2004;15(2):229-38.
  31. Yoo JH, Kim HI, Kim GW, Koo BS. A Case of Delirium with Traumatic Subdural Hemorrhage Patient Healed by Hwaeojeon. Journal of Oriental Neuropsychiatry. 2005;16(2):189-99.
  32. Lee EK, Choi CH, Lee JI, Chung DK. A clinical report of Delirium Tremens demonstrated Jusang. Journal of Oriental Neuropsychiatry. 2006;17(3):107-16.