Intraoperative Electroencephalography Alpha-Band Power Is a Better Proxy for Preoperative Low MoCA Under Propofol Compared With Sevoflurane

-
imageBACKGROUND: Preoperative abnormal cognitive status is a risk factor for postoperative complications yet remains underdiagnosed. During propofol general anesthesia, intraoperative electroencephalography (EEG) variables, such as alpha band power (α-BP), correlate with cognitive status. This relationship under sevoflurane is unclear. We investigated whether EEG biomarkers of poor cognitive status found under propofol could be extended to sevoflurane. METHODS: In this monocentric prospective observational study, 106 patients with intraoperative EEG monitoring were included (propofol/sevoflurane = 55/51). We administered the Montreal Cognitive Assessment (MoCA) scale to identify abnormal cognition (low MoCA) 1 day before intervention. EEG variables included delta to beta frequency band powers. Results were adjusted to age and drug dosage. We assessed depth of anesthesia (DoA) using the spectral edge frequency (SEF95) and maintained it within (8–13) Hz. RESULTS: The difference in α-BP between low and normal MoCA patients was significantly larger among propofol patients (propofol: 4.3 ± 4.8 dB versus sevoflurane: 1.5 ± 3.4 dB, P = .022). SEF95 and age were not statistically different between sevoflurane and propofol groups. After adjusting to age and dose, low α-BP was significantly associated with low MoCA under propofol (odds ratio [OR] [confidence interval {CI}] = 0.39 [0.16–0.94], P = .034), but not under sevoflurane, where theta-band power was significantly associated with low MoCA (OR [CI] = 0.31 [0.13–0.73], P = .007). CONCLUSIONS: We suggest that intraoperative EEG biomarkers of abnormal cognition differ between propofol and sevoflurane under general anesthesia.

from Anesthesia & Analgesia - Latest Articles https://ift.tt/HEzmC1g
via IFTTT

Popular posts from this blog

Danavorexton (TAK-925): A Promising Breakthrough in Combating Opioid-Induced Respiratory Depression

-
Danavorexton (TAK-925): A Promising Breakthrough in Combating Opioid-Induced Respiratory Depression Danavorexton (TAK-925): A Promising Breakthrough in Combating Opioid-Induced Respiratory Depression Opioids remain a cornerstone of pain management in clinical settings, yet their use is shadowed by life-threatening side effects, including respiratory depression and excessive sedation. A recent podcast episode from Anesthesiology ’s featured author series highlights a groundbreaking solution: danavorexton (TAK-925) , an orexin receptor 2 agonist that could revolutionize how we manage opioid-related complications. What Is Danavorexton (TAK-925)? Danavorexton is a selective agonist of the orexin-2 receptor (OX2R), a key player in regulating wakefulness and respiration. Orexins (also known as hypocretins) are neuropeptides produced in the hypothalamus that activate OX1R and OX2R receptors, influencing arousal, appetite, and...
Read more

Podcast and Review of the Fundamentals, Applications, and Limitations of Cerebral Oximetry

-
Image
Cerebral Oximetry - An Introduction Review of the Fundamentals, Applications, and Limitations of Cerebral Oximetry 1. Executive Summary: This document provides an overview of cerebral oximetry, a non-invasive technique used to monitor brain oxygenation using near-infrared spectroscopy (NIRS). The briefing covers its principles, clinical applications, limitations, and future directions. While cerebral oximetry shows promise for real-time monitoring of cerebral perfusion, particularly in high-risk surgical scenarios, it is essential to understand its limitations and interpret its data with caution. 👉 Ways to Show Your Love & Support for the Channel and blog ❤️Donate & Support My Work: https://bit.ly/4h1uv3G 🩷Support by ko-fi : https://bit.ly/3BYWlyy 💚buy me a cup of coffee ☕: https://bit.ly/3PoqVVe 2. Introduction: The document highlights that "in patients under deep sedation or general anaesthesia, monitoring brain perfusion is crucial for the early detection of cere...
Read more

Remimazolam Reduces Risk for Intraoperative Hypotension in Interventional Radiology

-
 According to a new study reported on Anesthesiology News, an anesthetic combination of remimazolam (Byfavo, Eagle) and fentanyl offers advantages for maintaining hemodynamic stability during short outpatient interventional radiology (IR) procedures. The article likely discusses the following key points: Comparison: The study compared the effectiveness of different anesthetic combinations commonly used for IR procedures at an outpatient surgery center. Focus: The central theme is likely finding an anesthetic approach that minimizes intraoperative hypotension (low blood pressure during surgery) for patient safety. Benefits of Remimazolam: The study suggests that remimazolam, combined with fentanyl, may offer advantages compared to other anesthetic combinations used in IR procedures. Potential benefits might include: Reduced risk of intraoperative hypotension Maintaining hemodynamic stability for patients Note: To understand the full details and specific findings of the ...
Read more