Intraoperative EEG Monitoring and Postoperative Delirium in Elderly Patients With Sevoflurane Anesthesia
Study Details
Study Description
Brief Summary
Delirium is an acute onset of attentional and cognitive impairment. BIS guided anesthesia can reduce the incidence of postoperative delirium. Long term electroencephalogram (EEG) suppression during operation is related to postoperative delirium. The latest research shows that the anesthesia depth guided by EEG does not reduce the incidence of postoperative delirium. The purpose of this study was to explore the relationship between anesthesia exposure with different minimum alveolar concentration(MAC) and postoperative delirium(POD), and to observe the characteristics of EEG.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
More and more studies have focused on the relationship between EEG inhibition and postoperative delirium in general anesthesia. At present, there are two kinds of commonly processed quantitative EEG monitoring to evaluate the depth of anesthesia, one is bispectral index (BIS) and the other is patient state index (PSI). The relationship between intraoperative anesthetic exposure and postoperative delirium is unclear, or whether potential patient characteristics increase the risk of EEG suppression and postoperative delirium.
Gastrointestinal surgery can lead to long-term changes in colonic flora, which can remotely regulate brain function through the gut brain axis. We speculated that the abnormal composition of intestinal flora before abdominal operation might be the influencing factor of POD.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: light general anesthesia During anesthesia maintenance, patients were received with low concentration sevoflurane to maintain a target of 0.8 MAC. |
Drug: Low MAC
To maintain a target of sevoflurane inhalation concentration 0.8 MAC.
|
| Experimental: deep general anesthesia During anesthesia maintenance, patients were received with high concentration sevoflurane to maintain a target of 1.0 MAC. |
Drug: High MAC
To maintain a target of sevoflurane inhalation concentration 1.0 MAC.
|
Outcome Measures
Primary Outcome Measures
- Incidence of POD [The 1st day after the surgery]
Incidence of POD after surgery
- Incidence of POD [The 2nd day after the surgery]
Incidence of POD after surgery
- Incidence of POD [The 3rd day after the surgery]
Incidence of POD after surgery
- Incidence of POD [The 5th day after the surgery]
Incidence of POD after surgery
- Incidence of POD [The 7th day after the surgery]
Incidence of POD after surgery
Secondary Outcome Measures
- EEG burst inhibition [During surgery]
Frequency of EEG burst inhibition
- EEG burst inhibition [During surgery]
Duration of EEG burst inhibition
- Incidence of adverse events [30-day after surgery]
Incidence of adverse events after surgery
- length of stay [From 1st day after the surgery to 2 weeks]
length of stay after surgery
- 30-day mortality [30-day after surgery]
30-day mortality after surgery
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Clinical diagnosis of gastrointestinal diseases
-
Patients were aged 60 to 90 years
-
American Society of Anesthesiologists (ASA) risk classification II-IV
-
Patients were scheduled to undergo elective major abdominal operation(with a anticipated time of 2-6 h)
Exclusion Criteria:
-
Preoperative dementia or cognitive impairment
-
Mental instability or mental illness
-
Patients with any factors affecting cognitive assessment, such as language, vision and hearing impairment
-
Any cerebrovascular accident occurred within 3 months, such as stroke etc
-
Previous history of delirium
-
Known hypersensitivity to sevoflurane or history of malignant hyperthermia
-
Abuse of narcotic sedative and analgesic drugs
-
Those who have reoperation within 7 days after operation
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | The First Affiliated Hospital of Anhui Medical University | Hefei | Anhui | China | 230022 |
Sponsors and Collaborators
- The First Affiliated Hospital of Anhui Medical University
Investigators
- Principal Investigator: Xuesheng Liu, MD.PHD, The First Affiliated Hospital of Anhui Medical University
Study Documents (Full-Text)
None provided.More Information
Publications
- Chan MT, Cheng BC, Lee TM, Gin T; CODA Trial Group. BIS-guided anesthesia decreases postoperative delirium and cognitive decline. J Neurosurg Anesthesiol. 2013 Jan;25(1):33-42. doi: 10.1097/ANA.0b013e3182712fba.
- Chaput AJ, Bryson GL. Postoperative delirium: risk factors and management: continuing professional development. Can J Anaesth. 2012 Mar;59(3):304-20. doi: 10.1007/s12630-011-9658-4. Epub 2012 Feb 4. Review. English, French.
- Fritz BA, Kalarickal PL, Maybrier HR, Muench MR, Dearth D, Chen Y, Escallier KE, Ben Abdallah A, Lin N, Avidan MS. Intraoperative Electroencephalogram Suppression Predicts Postoperative Delirium. Anesth Analg. 2016 Jan;122(1):234-42. doi: 10.1213/ANE.0000000000000989.
- Ridaura V, Belkaid Y. Gut microbiota: the link to your second brain. Cell. 2015 Apr 9;161(2):193-4. doi: 10.1016/j.cell.2015.03.033.
- Wildes TS, Mickle AM, Ben Abdallah A, Maybrier HR, Oberhaus J, Budelier TP, Kronzer A, McKinnon SL, Park D, Torres BA, Graetz TJ, Emmert DA, Palanca BJ, Goswami S, Jordan K, Lin N, Fritz BA, Stevens TW, Jacobsohn E, Schmitt EM, Inouye SK, Stark S, Lenze EJ, Avidan MS; ENGAGES Research Group. Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery: The ENGAGES Randomized Clinical Trial. JAMA. 2019 Feb 5;321(5):473-483. doi: 10.1001/jama.2018.22005.
- 201912