It has been a while since I’ve had a patient with postoperative alcohol withdrawal. I can still recall my first exposure to this problem as a 3rd year medical student at the Veteran’s Hospital. It was my first clinical rotation – surgery service at the VA.
The older term delirium tremens may be used in this context to describe the combined symptoms of confusion (type C), hyperadrenergic state (type B), and CNS excitation (type A)
Respiratory arrest -- 14% vs 4%.
Mechanical restraints used -- 57% vs 42% .
Delirium present -- 79% vs 29%. When present, delirium lasted a mean (SD) of 3.2 days in the preprotocol group and 3.3 days in the protocol group.
Violence (such as biting, scratching, kicking, verbal outbursts, and other violent manifestations) present -- 36% vs 8%.
One or more wound complications present -- 50% vs 46%.
No seizures, falls, or deaths occurred in either cohort during the inpatient stay. No patient developed delirium tremens.
The article is worth the review even with the small number of subjects.