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Electroencephalography-Guided Anesthesia and Delirium in Older Adults.
JAMA
November 2024
Department of Anesthesiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Electroencephalography-Guided Anesthesia and Delirium in Older Adults-Reply.
JAMA
November 2024
Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri.
Electroencephalography-Guided Anesthesia and Delirium in Older Adults After Cardiac Surgery: The ENGAGES-Canada Randomized Clinical Trial.
JAMA
July 2024
Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri.
Article Synopsis
- Intraoperative EEG suppression during anesthesia can indicate excessive sedation and has been linked to higher rates of postoperative delirium, particularly after cardiac surgeries.
- A randomized clinical trial involving 1140 adults aged 60 and older investigated if EEG-guided anesthesia could reduce the incidence of delirium compared to usual anesthesia care.
- Results showed that there was no significant difference in postoperative delirium rates (around 18%) between the EEG-guided group and the usual care group, despite lower anesthetic doses and less time spent in EEG suppression in the EEG-guided group.
Processed electroencephalography-guided general anesthesia and norepinephrine requirements: A randomized trial in patients having vascular surgery.
J Clin Anesth
August 2024
Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; OutcomesResearch Consortium, Cleveland, OH, USA.
Study Objective: Processed electroencephalography (pEEG) may help clinicians optimize depth of general anesthesia. Avoiding excessive depth of anesthesia may reduce intraoperative hypotension and the need for vasopressors. We tested the hypothesis that pEEG-guided - compared to non-pEEG-guided - general anesthesia reduces the amount of norepinephrine needed to keep intraoperative mean arterial pressure above 65 mmHg in patients having vascular surgery.
View Article and Find Full Text PDFPro-Con Debate: Electroencephalography-Guided Anesthesia for Reducing Postoperative Delirium.
Anesth Analg
November 2023
Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri.
Postoperative delirium (POD) has significant implications on morbidity, mortality, and health care expenditures. Monitoring electroencephalography (EEG) to adjust anesthetic management has gained interest as a strategy to mitigate POD. In this Pro-Con commentary article, the pro side supports the use of EEG to reduce POD, citing an empiric reduction in POD with processed EEG (pEEG)-guided general anesthesia found in several studies and recent meta-analysis.
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