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Anesthetic depth and long-term survival: an update
Kate Leslie1,2,3, Timothy G Short4
1Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia. kate.leslie@mh.org.au.
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|September 18, 2015
Summary
Anesthetic depth, measured by bispectral index (BIS), may impact long-term survival. While observational studies suggest deep anesthesia increases mortality risk, definitive evidence from randomized trials is still needed.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Surgical Outcomes Research
Background:
- Anesthetic depth monitoring is crucial for patient safety.
- The relationship between anesthetic depth and long-term surgical outcomes remains an area of active investigation.
Purpose of the Study:
- To review existing evidence linking anesthetic depth to long-term survival rates following surgical procedures.
Main Methods:
- A comprehensive literature search was conducted using PubMed.
- Included studies compared patient mortality based on processed electroencephalographic index (e.g., bispectral index [BIS]) values.
- Studies in all languages were considered.
Main Results:
- Most observational studies indicate a significant association between deep general anesthesia (BIS < 45) and increased mortality.
- Deep anesthesia may also correlate with myocardial infarction and postoperative cognitive decline.
- Randomized controlled trials yielded mixed results, with one showing worse outcomes at BIS = 50 and others finding no difference in mortality between different BIS ranges.
Conclusions:
- Current evidence regarding anesthetic depth and long-term survival is inconclusive.
- Further randomized controlled trials, with precise control of arterial blood pressure, are necessary to clarify this relationship.
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