With otolaryngeal cancer receiving surgery with general anesthesia\r\n* Please note we are purposefully including patients with higher predisposition to delirium as we are investigating potential preventive strategies for this diagnosis of multiple etiologies; patients at higher risk of delirium (e.g., advanced age, chronic hypertension) will be included in our study; additionally, other common risk factors that exist in this patient population (e.g., alcohol or nicotine use) are thought to contribute to delirium postoperatively
Part 1: patients will be excluded if (1) have clinical evidence of cognitive failure as evidenced by Memorial Delirium Assessment Scale score of ? 13 at baseline
Delirium (i.e., score >13 on the Memorial Delirium Assessment Scale; range 1-30).
Delirium (i.e. Memorial Delirium Rating Scale > 13)
PATIENTS: Hyperactive or mixed delirium with RASS >= 1 in the past 24 hours (h)
Memorial Delirium Rating Scale > 13
Delirium (i.e., Memorial Delirium Rating Scale > 13)
Delirium (i.e. memorial delirium rating scale > 13)
Cognitive impairment with a Memorial Delirium Assessment Scale (MDAS) score of 7 or higher or diagnosed with neurocognitive impairment by the treating SCC physician
Presence of relatively intact cognition defined by normal memorial delirium assessment scale (< 7/30); sign written informed consent
Memorial Delirium Assessment Scale > 13/30
Patients must have no clinical evidence of cognitive impairment as determined by the palliative care physician (Memorial Delirium Assessment Score >= 7)
Hyperactive/mixed delirium with RASS >= 2 in the last 24 hours
At the patient’s bedside at least 4 hours each day during patient delirium episode
Delirium (i.e. memorial delirium rating scale > 13)
Delirium (i.e. Memorial delirium rating scale > 13)
Delirium (i.e. memorial delirium rating scale > 13)
Memorial delirium assessment scale =< 13
Have no clinical evidence of cognitive failure as evidenced by Memorial Delirium Assessment Scale (MDAS) score of =< 13 at baseline
Memorial delirium assessment scale =< 13
Altered cognition (as assessed routinely in the Supportive Care Clinic using the Memorial Delirium Assessment Scale [MDAS], with a score of >= 7/30)
Patients with normal cognitive status (Memorial Delirium Assessment Scale [MDAS] =< 6/30) who are able to understand the nature and purpose of the study and have the ability to complete the consent process