EEG-Guided Anesthesia Does Not Cut Postop Delirium in Seniors

WEDNESDAY, Feb. 6, 2019 — For older adults undergoing surgery, electroencephalogram (EEG)-guided anesthetic administration is not associated with a reduction in postoperative delirium, according to a study published in the Feb. 5 issue of the Journal of the American Medical Association.

Troy S. Wildes, M.D., from the Washington University School of Medicine in St. Louis, and colleagues conducted a randomized clinical trial of 1,232 adults aged 60 years and older undergoing major surgery and receiving general anesthesia. Patients were randomly assigned to receive EEG-guided anesthetic administration (614 patients) or usual anesthetic care (618 patients).

The researchers found that 26.0 and 23.0 percent of patients in the EEG-guided and usual care groups had delirium during postoperative days 1 to 5 (difference, 3.0 percent; 95 percent confidence interval, −2.0 to 8.0 percent; P = 0.22). The guided group had lower median end-tidal volatile anesthetic concentration (0.69 versus 0.80 minimum alveolar concentration; difference, − 0.11; 95 percent confidence interval, −0.13 to −0.10) and significantly less median cumulative time with EEG suppression (7 versus 13 minutes; difference, −6.0; 95 percent confidence interval, −9.9 to −2.1). The groups did not differ significantly in terms of the median cumulative time to mean arterial pressure less than 60 mm Hg (seven minutes for both; difference, 0.0; 95 percent confidence interval, −1.7 to 1.7).

“We found that preventing suppression by closely monitoring and then adjusting doses of anesthesia made delirium no less likely,” Wildes said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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Posted: February 2019

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