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Neuromonitoring in the elderly.
Curr Opin Anaesthesiol ; 32(1): 101-107, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30507680


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.


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.


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.





Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos Operatórios / Disfunção Cognitiva / Monitorização Neurofisiológica Intraoperatória / Delírio do Despertar / Anestesia Geral Tipo de estudo: Guia de prática clínica Aspecto clínico: Etiologia / Prognóstico Limite: Idoso / Humanos Idioma: Inglês Revista: Curr Opin Anaesthesiol Assunto da revista: Anestesiologia Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Alemanha