Does EEG-Guided Anesthesia Prevent Postop Delirium?

Does EEG-Guided Anesthesia Prevent Postop Delirium?

TOPLINE:

Within the ENGAGES-Canada trial, patients who received electroencephalography (EEG)-guided anesthesia or regular care at some level of cardiac surgical map skilled same rates of postoperative delirium.

METHODOLOGY:

  • ENGAGES-Canada became a randomized clinical trial sharp 1140 patients veteran 60 years or older undergoing cardiac surgical map at four Canadian hospitals.
  • Participants had been randomly assigned to receive both EEG-guided anesthesia or regular care —on the root of ranges of expired anesthetic gasses and hemodynamics — with the principle end result being the incidence of delirium at some level of postoperative days 1-5.

TAKEAWAY:

  • EEG-guided anesthesia did no longer vastly decrease the incidence of postoperative delirium when put next with regular care, with roughly 18% of patients in both crew experiencing the condition.
  • The survey urged that minimizing the time spent in EEG suppression and decreasing the administration of unstable anesthetics might perhaps well no longer influence delirium outcomes in older adults after cardiac surgical map.

IN PRACTICE:

The fresh discovering “highlights a key request about postoperative delirium of relevance to patients undergoing both cardiac and noncardiac surgical procedures,” Miles Berger, MD, PhD, of Duke University, in Durham, North Carolina, and Mark D. Neuman, MD, MSc, of the University of Pennsylvania, in Philadelphia, wrote in an editorial accompanying the journal article. “Why, at a given anesthetic dose, manufacture positive patients prove EEG suppression whereas others manufacture no longer? And why manufacture patients who are extra sensitive to developing EEG suppression basically basically based on anesthetics extra veritably originate postoperative delirium? Answering these questions might perhaps well encourage to title participants at supreme postoperative delirium menace and target these patients for delirium prevention interventions.”

SOURCE:

The survey became led by Alain Deschamps, MD, PhD, of the Montreal Heart Institute, Montreal, Quebec, Canada, and became printed online on June 10, 2024, in JAMA.

LIMITATIONS:

No matter a serious good deal in EEG suppression time, a higher good deal shall be required to beget an imprint on the incidence of postoperative delirium, in step with the authors. The 17.5% decrease within the administration of unstable anesthetic agents within the patients who received EEG-guided care might perhaps well beget been insufficient to forestall delirium.

DISCLOSURES:

Neuman reported receiving grants from the PCORI and the Donaghue Foundation start air the submitted work. Berger reported receiving grants from the National Institute on Ageing/National Institutes of Health at some level of the survey and nonfinancial assist from Massimo for a evaluate survey start air the submitted work.

This article became created the exhaust of a number of editorial tools, at the side of AI, as phase of the process. Human editors reviewed this philosophize material sooner than publication.

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