British journal of anaesthesia
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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.
pearl -
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.
pearl -
Systematic reviews to date have neglected to exclusively include studies using a validated diagnostic scale for postoperative delirium and monitoring patients for more than 24 h. Evidence on current risk factors is evolving with significantly heterogeneous study designs, inconsistent reporting of results, and a lack of adjustment for bias. ⋯ Risk factors can assist in clinical decision-making and identification of high-risk patients. Literature analysis identified inconsistent methodology, leading to challenges in interpretation. A standardised format and evidence-based approach should guide future studies.
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Systematic reviews to date have neglected to exclusively include studies using a validated diagnostic scale for postoperative delirium and monitoring patients for more than 24 h. Evidence on current risk factors is evolving with significantly heterogeneous study designs, inconsistent reporting of results, and a lack of adjustment for bias. ⋯ Risk factors can assist in clinical decision-making and identification of high-risk patients. Literature analysis identified inconsistent methodology, leading to challenges in interpretation. A standardised format and evidence-based approach should guide future studies.
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It remains controversial whether general anaesthetic drugs contribute to perioperative neurocognitive disorders in adult patients. Preclinical studies have generated conflicting results, likely because of differing animal models, study protocols, and measured outcomes. This scoping review of preclinical studies addressed the question: 'Do general anaesthetic drugs cause cognitive deficits in adult animals that persist after the drugs have been eliminated from the brain?' ⋯ Most studies reported cognitive deficits after general anaesthesia, with age, use of volatile anaesthetic drugs, and duration of anaesthesia as risk factors. Recommendations to improve study design and guide future research are presented.