Depth of Anesthesia and Postoperative Delirium

Abbott, Tom; Pearse, Rupert M

doi:10.1001/jama.2019.0164

Cited by 29 publications

(15 citation statements)

References 15 publications

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“…The inclusion criteria are as follows: (1) patients meeting the indications for general anesthesia [ 5 ]; (2) patients whose operation time exceeds two hours; (3) patients whose American Association for Standardization (ASA) anesthesia classification [ 6 ] is between grade II and III; (4) patients whose body mass index (BMI) ≤ 30 kg/m 2 ; and (5) patients who have signed informed consent form.…”

Section: Methodsmentioning

confidence: 99%

Warning and Nursing Experience of Anesthesia Depth Monitoring for Patients with General Anesthesia Delayed to Leave Anesthesia Recovery Room and Delirium

Xuan¹,

2022

Emergency Medicine International

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Affected by the residues of narcotic drugs, patients under general anesthesia are vulnerable to emergence of agitation, delirium, hemodynamic changes, and other adverse events in the recovery period of anesthesia. Therefore, it is necessary to strengthen the observation and care of these patients. Depth of anesthesia monitoring (DAM) has always been a concern for anesthesiologists, but there are few reports related to it. This study compared the early warning value of DAM for patients under general anesthesia with delayed exit from the anesthesia recovery unit (PACU) and delirium and summarized the related nursing experience. The results showed that DAM could reduce the incidence of complications in patients under general anesthesia, reduce the incidence of delirium, shorten the time of postoperative anesthesia recovery and PACU observation time, reduce the workload of nursing staff, and improve nursing satisfaction. DAM plays an important role in improving the quality and efficiency of care in PACU.

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Section: Methodsmentioning

confidence: 99%

Warning and Nursing Experience of Anesthesia Depth Monitoring for Patients with General Anesthesia Delayed to Leave Anesthesia Recovery Room and Delirium

Xuan¹,

2022

Emergency Medicine International

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“…77,79,80 The lack of a statistical difference might partly be explained by the fact that all patients received multicomponent safety interventions to reduce postoperative confusion, and such interventions may have reduced the overall incidence of clinically detectable PD, such that any potentially therapeutic effects of pEEG-guided care could become negated. 83 Furthermore, it is important to note that both groups received arguably excessive anesthetic exposure (duration of BIS <40 = 32 vs 60 minutes; difference = 28 minutes; 95% CI, 18.0–38.0; P < .001) and both demonstrated intraoperative burst-suppression (7 vs 13 minutes; difference = 6 minutes; 95% CI, 2.2–9.9; P < .001). Indeed, the durations of both EEG burst-suppression and BIS <40 were significantly longer among patients with delirium compared to those without, but this was not the focus of the ENGAGES study.…”

Section: Postoperative Deliriummentioning

confidence: 99%

Electroencephalographic Burst-Suppression, Perioperative Neuroprotection, Postoperative Cognitive Function, and Mortality: A Focused Narrative Review of the Literature

Ma¹,

Bebawy

2021

Anesthesia &Amp; Analgesia

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Burst-suppression is an electroencephalographic pattern that results from a diverse array of pathophysiological causes and/or metabolic neuronal suppression secondary to the administration of anesthetic medications. The purpose of this review is to provide an overview of the physiological mechanisms that underlie the burst-suppression pattern and to present in a comprehensive way the available evidence both supporting and in opposition to the clinical use of this electroencephalographic pattern as a therapeutic measure in various perioperative settings. (Anesth Analg 2022;135:79-90) GLOSSARY ACNS = American Clinical Neurophysiology Society; ADAPT-2 = Anesthetic Depth and Postoperative Delirium Trial-2; ATP = adenosine triphosphate; [ATP] I = intracellular ATP concentration; BIS = bispectral index; BSR = burst-suppression ratio; CBF = cerebral blood flow; CEA = carotid endarterectomy; CI = confidence interval; CMRO2 = cerebral metabolic rate of oxygen consumption; CPB = cardiopulmonary bypass; CV = cardiovascular; EEG = electroencephalogram; ENGAGES = Electroencephalography Guidance of Anesthesia to Alleviate Geriatric Syndromes; ET = end-tidal; GABA = gamma-aminobutyric acid; GOS = Glasgow Outcome Scale; HR = hazard ratio; IAR = intraoperative aneurysm rupture; ICP = intracranial pressure; ICU = intensive care unit; K ATP = ATPgated potassium channels; MAC = minimum alveolar concentration; MAP = mean arterial pressure; OR = odds ratio; PACU = postanesthetic care unit; PD = postoperative delirium; pEEG = processed EEG; POD = postoperative day; RCT = randomized controlled trial; TC = temporary clip Basic, Clinical and Systems Neuroscience

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“…The main goal is to titrate drugs in such a manner that a very high probability of unconsciousness is obtained without overdosing because excessive concentrations can cause hypotension, reduced cardiac output, and excessive CNS depression with possibly increased incidence of postoperative delirium. 39 One anesthetic dose guiding tool is based on monitoring of drug-induced CNS depression, which results in unconsciousness. This can be done through raw EEG observation, EEG analysis such as BIS determination, or auditory evoked potential analysis.…”

Section: Pragmatic Approach To Achieve the Anesthetic Statementioning

confidence: 99%

Section: Pragmatic Approach To Achieve the Anesthetic Statementioning

confidence: 99%

End-tidal Anesthetic Concentration: Monitoring, Interpretation, and Clinical Application

Hendrickx

Wolf

2022

Anesthesiology

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Depth of Anesthesia and Postoperative Delirium

Cited by 29 publications

References 15 publications

Warning and Nursing Experience of Anesthesia Depth Monitoring for Patients with General Anesthesia Delayed to Leave Anesthesia Recovery Room and Delirium

Warning and Nursing Experience of Anesthesia Depth Monitoring for Patients with General Anesthesia Delayed to Leave Anesthesia Recovery Room and Delirium

Electroencephalographic Burst-Suppression, Perioperative Neuroprotection, Postoperative Cognitive Function, and Mortality: A Focused Narrative Review of the Literature

End-tidal Anesthetic Concentration: Monitoring, Interpretation, and Clinical Application

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