British journal of anaesthesia
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Recent trials are conflicting as to whether titration of anaesthetic dose using electroencephalography monitoring reduces postoperative delirium. Titration to anaesthetic dose itself might yield clearer conclusions. We analysed our observational cohort to clarify both dose ranges for trials of anaesthetic dose and biological plausibility of anaesthetic dose influencing delirium. ⋯ NCT03124303, NCT01980511.
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Review Meta Analysis
Processed electroencephalography-guided general anaesthesia to reduce postoperative delirium: a systematic review and meta-analysis.
Meta-analysis pooled data continues to suggest that processed-EEG guided general anaesthesia is associated with a slightly lower incidence of postoperative delirium compared to usual care or deeper-guided GA.
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Multicenter Study Observational Study
Functional brain network and trail making test changes following major surgery and postoperative delirium: a prospective, multicentre, observational cohort study.
Delirium is a frequent complication after surgery in older adults and is associated with an increased risk of long-term cognitive impairment and dementia. Disturbances in functional brain networks were previously reported during delirium. We hypothesised that alterations in functional brain networks persist after remission of postoperative delirium and that functional brain network alterations are associated with long-term cognitive impairment. ⋯ NCT02265263.
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Editorial Comment
Linking and unlinking the paediatric brain: age-invariant neural correlates of general anaesthesia.
There is no single electroencephalographic metric for general anaesthesia that is validated for both children and adults. This is, in part, because of the changing electroencephalographic features associated with development. Here, we discuss how alterations in correlated brain activity during general anaesthesia advance our understanding of anaesthetic monitoring and the neurobiology of consciousness.