Mengrong Miao1, Yuehua Xu1,2, Mingyang Sun1, Enqiang Chang1, Xuhui Cong1, Jiaqiang Zhang3. 1. Department of Anesthesia and Perioperative Medicine, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China. 2. Department of Surgery, First Hospital of Henan Provincial People's Hospital, Zhengzhou, Henan, China. 3. Department of Anesthesia and Perioperative Medicine, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China. hnmzxh@163.com.
Abstract
BACKGROUND AND AIMS: Perioperative neurocognitive disorders (PND) are common in elderly patients after surgery. It has been reported that BIS-guided anesthesia potentially influenced the occurrence of PND. Therefore, we conducted this systematic review and meta-analysis to explore the associations between bispectral index (BIS) monitoring and PND. METHODS: Two researchers independently searched for relevant randomized controlled trials (RCTs) in PubMed, EMBASE, and the Cochrane Library (CENTRAL) using keywords related to the BIS and PND from inception to April 22, 2019. Odds ratios (OR) with 95% CI were calculated using a random effects model. RESULTS: Nine RCTs involving 4023 participants aged 60 years or older were included into this meta-analysis. BIS-guided anesthesia was not associated with lower incidence of POD (random effects; OR: 0.69; 95% CI 0.48, 1.01), delayed neurocognitive recovery (DNR) at 1 day, 7 days (random effects; OR: 0.14; 95% CI 0.02, 1.23; random effects; OR: 0.97; 95% CI 0.57, 1.63), and postoperative neurocognitive disorder (NCD) at 90 days and 1 year after surgery in older adults (random effects; OR:0.72; 95% CI 0.52, 1.00; random effects; OR: 0.26; 95% CI 0.03, 2.47). CONCLUSIONS: No definite evidence demonstrated that BIS-guided anesthesia decreased the incidence of POD, DNR and postoperative NCD in older patients. More homogeneous RCTs assessing the efficacy of BIS monitoring on reducing the occurrence of these perioperative cognitive disorders are needed.
BACKGROUND AND AIMS: Perioperative neurocognitive disorders (PND) are common in elderly patients after surgery. It has been reported that BIS-guided anesthesia potentially influenced the occurrence of PND. Therefore, we conducted this systematic review and meta-analysis to explore the associations between bispectral index (BIS) monitoring and PND. METHODS: Two researchers independently searched for relevant randomized controlled trials (RCTs) in PubMed, EMBASE, and the Cochrane Library (CENTRAL) using keywords related to the BIS and PND from inception to April 22, 2019. Odds ratios (OR) with 95% CI were calculated using a random effects model. RESULTS: Nine RCTs involving 4023 participants aged 60 years or older were included into this meta-analysis. BIS-guided anesthesia was not associated with lower incidence of POD (random effects; OR: 0.69; 95% CI 0.48, 1.01), delayed neurocognitive recovery (DNR) at 1 day, 7 days (random effects; OR: 0.14; 95% CI 0.02, 1.23; random effects; OR: 0.97; 95% CI 0.57, 1.63), and postoperative neurocognitive disorder (NCD) at 90 days and 1 year after surgery in older adults (random effects; OR:0.72; 95% CI 0.52, 1.00; random effects; OR: 0.26; 95% CI 0.03, 2.47). CONCLUSIONS: No definite evidence demonstrated that BIS-guided anesthesia decreased the incidence of POD, DNR and postoperative NCD in older patients. More homogeneous RCTs assessing the efficacy of BIS monitoring on reducing the occurrence of these perioperative cognitive disorders are needed.
Authors: Troy S Wildes; Angela M Mickle; Arbi Ben Abdallah; Hannah R Maybrier; Jordan Oberhaus; Thaddeus P Budelier; Alex Kronzer; Sherry L McKinnon; Daniel Park; Brian A Torres; Thomas J Graetz; Daniel A Emmert; Ben J Palanca; Shreya Goswami; Katherine Jordan; Nan Lin; Bradley A Fritz; Tracey W Stevens; Eric Jacobsohn; Eva M Schmitt; Sharon K Inouye; Susan Stark; Eric J Lenze; Michael S Avidan Journal: JAMA Date: 2019-02-05 Impact factor: 56.272
Authors: Tim Johnson; Terri Monk; Lars S Rasmussen; Hanne Abildstrom; Peter Houx; Kari Korttila; Harrie M Kuipers; Chris D Hanning; Volkert D Siersma; Diana Kristensen; Jaume Canet; Maria Teresa Ibañaz; Jakob T Moller Journal: Anesthesiology Date: 2002-06 Impact factor: 7.892