Pfizer COVID-19 vaccine appointments are available to our patients. Sign up for Connect today to schedule your vaccination. Continue your routine care with us by scheduling an in-person appointment or Video Visit.

Processed electroencephalography-guided general anaesthesia to reduce postoperative delirium: a systematic review and meta-analysis.

TitleProcessed electroencephalography-guided general anaesthesia to reduce postoperative delirium: a systematic review and meta-analysis.
Publication TypeJournal Article
Year of Publication2022
AuthorsSumner M, Deng C, Evered L, Frampton C, Leslie K, Short T, Campbell D
JournalBr J Anaesth
Date Published2022 Feb 16
ISSN1471-6771
Abstract

BACKGROUND: Postoperative delirium (POD) is the most common serious postoperative complication in older adults. It has uncertain aetiology, limited preventative strategies, and poor long-term outcomes. This updated systematic review and meta-analysis aimed to estimate the effect of processed electroencephalography (pEEG)-guided general anaesthesia during surgery on POD incidence.

METHODS: We performed a systematic review and meta-analysis by searching OVID MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases. Studies of adult patients having general anaesthesia for any surgery where pEEG was used and POD was an outcome measure were included. Full-text reports of RCTs published from database inception until August 28, 2021, were included. Trials were excluded if sedation rather than general anaesthesia was administered, or the setting was intensive care. The primary outcome was POD assessed by validated tools. The study was prospectively registered at PROSPERO.

RESULTS: Nine studies, which included 4648 eligible subjects, were identified. The incidence of POD in the pEEG-guided general anaesthesia or lighter pEEG target group was 19.0% (440/2310) compared with 23.3% (545/2338) in the usual care or deeper pEEG target group (pooled odds ratio=0.78; 95% confidence interval, 0.60-1.00; P=0.054). Significant heterogeneity was detected (I2=53%).

CONCLUSIONS: Our primary analysis demonstrated a highly sensitive result with a pooled analysis of trials in which the intervention group adhered to manufacturer's recommended guidelines showing reduced incidence of POD with pEEG guidance. High clinical heterogeneity limits the inferences from this and any future meta-analyses.

CLINICAL TRIAL REGISTRATION: CRD42020199404 (PROSPERO).

DOI10.1016/j.bja.2022.01.006
Alternate JournalBr J Anaesth
PubMed ID35183345