Minimizing Surgical Anesthesia: Impact on Post-Operative Delirium Risk Explained

Study Examines Delirium in Older Patients Post-Surgery

Overview of Delirium in Older Adults

A recent study focused on the experiences of older patients with delirium following surgical procedures and investigated whether monitoring brain activity during anesthesia administration could influence this complication. Older patients seem to be particularly vulnerable to delirium during their recovery from surgery, a condition characterized by altered consciousness. Delirium not only hampers recovery but also causes distress among patients, caregivers, and hospital staff.

Research Objectives and Methodology

Researchers at Barnes-Jewish Hospital in St. Louis, USA, aimed to determine if monitoring brain activity during surgery, to optimize anesthesia delivery, had any effect on the incidence of delirium. To assess this, older patients undergoing anesthesia had their brain activity recorded, allowing the anesthesiologist to adjust the medications administered to prevent suppression. The incidence of delirium in these patients was then compared to a control group whose brain activity was not monitored. The findings were published in JAMA.

Study Results

Data was collected from a total of 1,213 patients. The analysis revealed that monitoring brain activity during anesthesia did not lead to a reduction in post-operative delirium. Patients were equally likely to experience delirium, regardless of whether their brain activity was measured.

Comparison with Previous Research

These results contrast with earlier studies that indicated that using technology to monitor brain activity during anesthesia could lower the risk of post-operative delirium. The researchers noted that the discrepancies in findings might be attributed to the varied quality of the studies. This particular study was specifically designed to focus on delirium, enhancing its quality compared to previous research where delirium was a secondary outcome.

Conclusions and Implications

The findings of this study do not support the practice of measuring brain activity to guide anesthetic administration during surgery. The researchers argued that such monitoring is labor-intensive and could divert the anesthesiologist’s attention from other critical observations necessary during the procedure.

Author and References

Written by Nicola Cribb, VetMB DVSc Dip.ACVS

References:
Wildes T, Mickle A, Abdallah A, et al. Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery. Jama. 2019;321(5):473–483. doi:10.1001/jama.2018.22005.