The absence of dominant alpha-oscillatory EEG activity during emergence from delta-dominant anesthesia predicts neurocognitive impairment- results from a prospective observational trial |
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| Institution: | 1. Department of Anaesthesiology and Intensive Care, Technical University of Munich, School of Medicine, Munich, Germany;2. Early Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany;3. Department of Anaesthesiology and Intensive Care, Universitätsklinikum Ulm, Ulm, Germany;4. Department of Anaesthesiology, Columbia University, New York, NY, USA;1. Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, United States of America;2. Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, United States of America;3. Department of Intensive Care and Resuscitation, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, United States of America;4. Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, United States of America;5. Cardiology Section, Department of Medicine, VA New York Harbor Healthcare System, New York, NY, United States of America;6. Department of Quantitative Health Sciences, Cleveland Clinic, OH, United States of America;1. Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America;2. New York Institute of Technology College of Osteopathic Medicine, Glen Head, NY, United States of America;1. Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA;2. School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA;1. Department of Anesthesiology, Wenling Maternity and Child Health Care Hospital, Taizhou, China;2. Department of Anesthesiology, Women''s Hospital, Zhejiang University School of Medicine, Hangzhou, China;1. Department of Anaesthetics and Pain Medicine, Sunshine Coast University Hospital, Birtinya, QLD, Australia;2. Registrar, Department of Anaesthetics and Pain Medicine, Sunshine Coast University Hospital, Birtinya, QLD, Australia;3. Registrar, Intensive Care Unit, The Alfred, Melbourne, VIC, Australia;4. Consultant Anaesthetist, Sunshine Coast University Hospital, Birtinya, QLD, Australia;5. Associate Professor, Griffith University, Birtinya, QLD, Australia;6. Senior Lecturer, Griffith University, Birtinya, QLD, Australia.;1. Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children''s Hospital at Stanford, Stanford, CA. USA;2. Department of Orthopedic Surgery, Lucile Packard Children''s Hospital at Stanford, Stanford, CA. USA;3. Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA |
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| Abstract: | Study objectivePostoperative neurocognitive disorders (PND) are common complications after surgery under general anesthesia. In our aging society the incidence of PND will increase. Hence, interdisciplinary efforts should be taken to minimize the occurrence of PND. Electroencephalographic (EEG) monitoring of brain activity during anesthesia or emergence from anesthesia is a promising tool to identify patients at risk. We therefore investigated whether we could identify specific EEG signatures during emergence of anesthesia that are associated with the occurrence of PND.Design and patientsWe performed a prospective observational investigation on 116 patients to evaluate the EEG features during emergence from general anesthesia dominated by slow delta waves in patients with and without delirium in the postoperative care unit (PACU-D) as assessed by the CAM-ICU and the RASS.Main resultsDuring emergence both the frontal and global EEG of patients with PACU-D were significantly different from patients without PACU-D. PACU-D patients had lower relative alpha power and reduced fronto-parietal alpha coherence.ConclusionsWith our analysis we show differences in EEG features associated with anesthesia emergence in patients with and without PACU-D. Frontal and global EEG alpha-band features could help to identify patients with PACU-D.Clinical trial number: NCT03287401 |
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