Effect of Auditory Evoked Potential-Guided Anaesthesia on Consumption of Anaesthetics and Early Postoperative Cognitive Dysfunction: a randomised controlled trial

Abstract

AEP monitoring allows dose reduction of anaesthetic agents, leading to better cardiovascular stability and decreased requirements for intra-operative fluids and vasopressors. Cognitive decline seen following minor ophthalmic surgery, even when anaesthesia is assessed clinically, is short-lived with no long-term sequelae.

Does Depth of Anesthesia Influence Postoperative Cognitive Dysfunction or Inflammatory Response Following Major ENT Surgery?

“…40% vs. 6%. In our previous study of 450 patients undergoing minor ophthalmic surgery the incidence was less than 1% in AEP-guided anesthesia group, which was significantly lower than controls [5]. This suggests that the extent of surgery may have a role in development of POCD.…”

Challenges in anaesthesia for elderly

“…However, the impact of extended monitoring and goal directed therapy on postoperative cognitive changes is not entirely clear. Carefully titrating anaesthesia using perioperative brain monitoring has been a research area of great interest [59]; cerebral oxygen oximetery can be measured by intra-operative nearinfrared spectroscopy (NIRS), and depth of anaesthesia can be guided by continuous recordings of electroencephalograms processed by a bispectral index (BIS) monitor or auditory evoked potentials [32,55,[59][60][61][62][63][64].…”

Middle latency auditory-evoked potential index for predicting the degree of consciousness of comatose patients in EDs

“…It continuously generates an MLAEP index (MLAEPi), which is a dimensionless number scaled between 99 (wide awake) and 0 (no brain activity), with differences between successive segments of the curve constructed from its amplitude. The aepEX plus monitor is being increasingly used to measure both the level of anesthesia and cerebral function instead of BIS values in ICUs [4,[7][8][9]. The effectiveness of MLAEPi monitoring at EDs in patients with cardiac arrest was previously reported, but apparently, no study has attempted to correlate the degree of disturbance of consciousness (DOC) changes with the MLAEPi [10].…”

“…Auditory-evoked potentials (AEPs) as well as BIS monitoring provide a good indication of the degree of consciousness under anesthesia in an operative setting [4]. In particular, cerebral function can be noninvasively monitored by measuring middle latency AEPs (MLAEPs) [5].…”