Incidence change of postoperative delirium after implementation of processed electroencephalography monitoring during surgery: a retrospective evaluation study

doi:10.1186/s12871-023-02293-9

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標題:	Incidence change of postoperative delirium after implementation of processed electroencephalography monitoring during surgery: a retrospective evaluation study
作者:	Chen, Yi-Chen Hung, I-Yin Hung, Kuo-Chuan Chang, Ying-Jen Chu, Chin-Chen Chen, Jen-Yin Ho, Chung-Han Yu, Chia-Hung
貢獻者:	Chi Mei Med Ctr, Dept Med Res Chi Mei Med Ctr, Dept Anesthesiol Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm, Coll Recreat & Hlth Management Chia Nan Univ Pharm & Sci, Coll Recreat & Hlth Management, Dept Recreat & Hlth Care Management Southern Taiwan Univ Sci & Technol, Dept Informat Management, 1 Nantai St Southern Taiwan Univ Sci & Technol, Dept Comp Sci & Informat Engn
關鍵字:	Postoperative delirium Processed electroencephalography General anesthesia Intravenous patient-controlled analgesia
日期:	2023
上傳時間:	2024-12-25 11:03:34 (UTC+8)
出版者:	BMC
摘要:	BackgroundPostoperative delirium (POD) is a common complication in the elderly, which is associated with poor outcomes after surgery. Recognized as predisposing factors for POD, anesthetic exposure and burst suppression during general anesthesia can be minimized with intraoperative processed electroencephalography (pEEG) monitoring. In this study, we aimed to evaluate whether implementation of intraoperative pEEG-guided anesthesia is associated with incidence change of POD.MethodsIn this retrospective evaluation study, we analyzed intravenous patient-controlled analgesia (IVPCA) dataset from 2013 to 2017. There were 7425 patients using IVPCA after a noncardiac procedure under general anesthesia. Patients incapable of operating the device independently, such as cognitive dysfunction or prolonged sedation, were declined and not involved in the dataset. After excluding patients who opted out within three days (N = 110) and those with missing data (N = 24), 7318 eligible participants were enrolled. Intraoperative pEEG has been implemented since July 2015. Participants having surgery after this time point had intraoperative pEEG applied before induction until full recovery. All related staff had been trained in the application of pEEG-guided anesthesia and the assessment of POD. Patients were screened twice daily for POD within 3 days after surgery by staff in the pain management team. In the first part of this study, we compared the incidence of POD and its trend from 2013 January-2015 July with 2015 July-2017 December. In the second part, we estimated odds ratios of risk factors for POD using multivariable logistic regression in case-control setting.ResultsThe incidence of POD decreased from 1.18 to 0.41% after the administration of intraoperative pEEG. For the age group >= 75 years, POD incidence decreased from 5.1 to 1.56%. Further analysis showed that patients with pEEG-guided anesthesia were associated with a lower odd of POD (aOR 0.33; 95% CI 0.18-0.60) than those without after adjusting for other covariates.ConclusionsImplementation of intraoperative pEEG was associated with a lower incidence of POD within 3 days after surgery, particularly in the elderly. Intraoperative pEEG might be reasonably considered as part of the strategy to prevent POD in the elder population.Trial registrationNot applicable.
關聯:	Bmc Anesthesiology, v.23, n.1, Article 330
显示于类别:	[行政單位] 456

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