Anaesthetic depth and delirium after major surgery: A randomized clinical t

Samenvatting

Background: Postoperative delirium is a frequent and debilitating complication following major surgical procedures, with detrimental consequences for patients and healthcare systems. Emerging evidence suggests that the depth of anesthesia may influence the occurrence of postoperative delirium, although this relationship remains poorly understood.
Methods: This randomized clinical trial investigated the impact of anaesthetic depth on postoperative delirium. A total of 300 patients, aged 60 years and older, undergoing elective major surgery, were randomly assigned to receive either light or deep anesthesia, with anesthesia depth monitored using the Bispectral Index (BIS). Postoperative delirium was assessed using standardized tools, including the Confusion Assessment Method (CAM) and the Delirium-O-Meter. Primary outcomes included the incidence of postoperative delirium, while secondary outcomes comprised postoperative complications and length of hospital stay.
Results: The deep anesthesia group exhibited a significantly lower incidence of postoperative delirium (8%) compared to the light anesthesia group (17%). Furthermore, patients in the deep anesthesia group had a shorter length of hospital stay. The study did not find a statistically significant difference in postoperative complications between the two groups.
Conclusion: This randomized clinical trial suggests that maintaining deeper levels of anesthesia during major surgery may be associated with a reduced incidence of postoperative delirium. These findings hold promising implications for perioperative care, patient safety, and healthcare resource utilization, necessitating further research to confirm and elaborate on these results, explore underlying mechanisms, and inform clinical practice.