Cerebral monitoring of anaesthesia on reducing cognitive dysfunction and postoperative delirium: a systematic review

The Journal of International Medical Research
Chunmei Luo, Weiwu Zou

Abstract

Objective To assess the efficacy of cerebrally monitoring the depth of anaesthesia in reducing postoperative cognitive dysfunction and postoperative delirium (POD). Methods MEDLINE, EMBASE, and Cochrane Library databases were searched following PRISMA statement guidelines. We included randomized clinical trials (RCTs) comparing electroencephalogram-based and routine care-guided titration of anaesthesia in a systematic review. The risk estimate from each RCT was pooled in a meta-analysis. The primary outcome was POD and long-term cognitive dysfunction. Subgroup analyses were conducted for the subtypes of intervention group and surgery. We identified five RCTs with a total sample size of 2,868 and with bispectral index (BIS) or auditory evoked potential (AEP) as interventions. Results The odds ratio (OR) for POD and long-term cognitive decline was 0.51 (95%CI: 0.35-0.76) and 0.69 (95%CI: 0.49-0.97), respectively. Significant heterogeneity was identified in the POD data. There was no significant difference between BIS- and AEP-based titration of anaesthesia in reducing the risk of POD. Extensive heterogeneity for cardiac and thoracic surgery was identified in the study population, and significant publication bias was found among t...Continue Reading

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Citations

Feb 6, 2019·JAMA : the Journal of the American Medical Association·Thomas E F Abbott, Rupert M Pearse
Oct 28, 2019·Current Opinion in Psychiatry·Lucia Chinnappa-QuinnPerminder S Sachdev
Oct 22, 2019·Minerva anestesiologica·Stefano RomagnoliZaccaria Ricci
Mar 27, 2020·The Journal of International Medical Research·Qi-Hong ShenXiao-Zong Yuan
Oct 20, 2020·Drugs & Aging·Joachim HansenJacob Steinmetz
Aug 5, 2021·Journal of Molecular Neuroscience : MN·Shunhong MaoChunhua Zhu
Aug 24, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Benjamin MilneGudrun Kunst

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