医学
脑电图
谵妄
术后认知功能障碍
神经认知
围手术期
麻醉剂
认知
发作性谵妄
术中意识
麻醉
认知功能衰退
重症监护医学
精神科
痴呆
内科学
疾病
作者
Susanne Koch,Claudia Spies
出处
期刊:Current Opinion in Anesthesiology
[Ovid Technologies (Wolters Kluwer)]
日期:2019-02-01
卷期号:32 (1): 101-107
被引量:20
标识
DOI:10.1097/aco.0000000000000677
摘要
Purpose of review To summarize recent recommendations on intraoperative electroencephalogram (EEG) neuromonitoring in the elderly aimed at the prevention of postoperative delirium and long-term neurocognitive decline. We discuss recent perioperative EEG investigations relating to aging and cognitive dysfunction, and their implications on intraoperative EEG neuromonitoring in elderly patients. Recent findings The incidence of postoperative delirium in elderly can be reduced by monitoring depth of anesthesia, using an index number (0–100) derived from processed frontal EEG readings. The recently published European Society of Anaesthesiology guideline on postoperative delirium in elderly now recommends guiding general anesthesia with such indices (Level A). However, intraoperative EEG signatures are heavily influenced by age, cognitive function, and choice of anesthetic agents. Detailed spectral EEG analysis and research on EEG-based functional connectivity provide new insights into the pathophysiology of neuronal excitability, which is seen in elderly patients with postoperative delirium. Summary Anesthesiologists should become acquainted with intraoperative EEG signatures and their relation to age, anesthetic agents, and the risk of postoperative cognitive complications. A working knowledge would allow an optimized and individualized provision of general anesthesia for the elderly.
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