The absence of dominant alpha-oscillatory EEG activity during emergence from delta-dominant anesthesia predicts neurocognitive impairment- results from a prospective observational trial

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) moni...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2022-11, Vol.82, p.110949-110949, Article 110949
Main Authors: Lutz, Rieke, Müller, Claudia, Dragovic, Srdjan, Schneider, Frederick, Ribbe, Katharina, Anders, Malte, Schmid, Sebastian, García, Paul S., Schneider, Gerhard, Kreuzer, Matthias, Kratzer, Stephan
Format: Article
Language:English
Subjects:
Anesthesiology
Automation
Consent
Delirium
Electroencephalography
General anesthesia
Intensive care
Intervention
Observational studies
Patients
Surgery
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Summary: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
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2022.110949