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Can Intraoperative Processed EEG Predict Postoperative Cognitive Dysfunction in the Elderly?

Stacie Deiner1, Xiaodong Luo2, Jeffrey H Silverstein3

  • 1Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Geriatrics and Palliative Care, Icahn School of Medicine at Mount Sinai, New York, New York.

Clinical Therapeutics
|December 2, 2015
PubMed
Summary
This summary is machine-generated.

Postoperative cognitive dysfunction (POCD) in the elderly is linked to less time in deep anesthesia states like burst suppression. Increasing burst suppression may help prevent POCD.

Keywords:
EEGanesthesiaburst suppressioncognitiongeriatrics

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Area of Science:

  • Anesthesiology
  • Neuroscience
  • Geriatric Medicine

Background:

  • Postoperative cognitive dysfunction (POCD) is a significant complication in elderly patients undergoing surgery.
  • Optimizing intraoperative anesthetic depth is a target for improving postoperative cognition.
  • Current measures of anesthetic depth may not fully capture risks associated with POCD.

Purpose of the Study:

  • To identify intraoperative processed electroencephalogram (EEG) parameters correlated with POCD in elderly patients.
  • To investigate the relationship between burst suppression and the incidence of POCD.

Main Methods:

  • Retrospective analysis of 105 patients aged over 68 undergoing major surgery.
  • Recorded intraoperative medications, hemodynamics, processed EEG, and cerebral oxygen saturation.
  • Cognitive assessments were performed before surgery and at 3 months postoperatively.

Main Results:

  • POCD occurred in 27% of patients completing follow-up.
  • Patients with POCD spent significantly less time in burst suppression (35 vs 96 minutes).
  • Less time with Bispectral Index <45 also correlated with POCD.

Conclusions:

  • Reduced time in deep anesthetic states, specifically burst suppression, is associated with POCD.
  • Burst suppression may have a protective effect against POCD.
  • Further research is needed to elucidate the role of burst suppression in POCD prevention.