Monitoring Anesthetic Depth and Prevention of Postoperative Delirium
DOI:
https://doi.org/10.5281/zenodo.23320761Keywords:
General anesthesia, Electroencephalography, Anesthesia monitoring, Postoperative delirium, Perioperative careAbstract
Postoperative delirium is a neuropsychiatric complication associated with adverse clinical outcomes, particularly in older patients undergoing surgical procedures. Electroencephalography-based anesthetic depth monitoring has been investigated as a strategy to individualize anesthetic administration and potentially reduce the occurrence of this complication. This study aimed to analyze the scientific evidence regarding the relationship between electroencephalographic monitoring of anesthetic depth and the prevention of postoperative delirium. An integrative literature review was conducted using a qualitative approach and narrative synthesis, considering studies on processed electroencephalography, the bispectral index, electroencephalographic suppression, and postoperative neurocognitive outcomes. The findings indicate that monitoring may assist in individualizing anesthetic administration and identifying brain activity patterns associated with neurological vulnerability. However, evidence regarding delirium prevention remains heterogeneous, and a consistent preventive effect cannot be established. It is concluded that electroencephalography should be used as a complementary clinical tool and integrated into multifactorial strategies for preventing postoperative delirium.
References
1. CAO, L. et al. Effect of processed electroencephalography-guided anesthesia on postoperative delirium: an updated systematic review and meta-analysis. International Journal of Surgery, v. 111, n. 11, p. 8540-8549, 2025. DOI: https://doi.org/10.1097/JS9.0000000000003046.
2. CHEN, Y. et al. Effects of EEG-guided anesthetic depth monitoring on delirium incidence across different age groups: a systematic review and meta-analysis. BMC Anesthesiology, v. 26, art. 153, 2026. DOI: https://doi.org/10.1186/s12871-026-03631-3.
3. EVERED, L. et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery: a 2018 update. British Journal of Anaesthesia, v. 121, n. 5, p. 1005-1012, 2018. DOI: https://doi.org/10.1016/j.bja.2017.11.087.
4. MACKENZIE, K. K. et al. Processed electroencephalogram monitoring and postoperative delirium: a systematic review and meta-analysis. Anesthesiology, v. 129, n. 3, p. 417-427, 2018. DOI: https://doi.org/10.1097/ALN.0000000000002323.
5. PUNJASAWADWONG, Y. et al. Processed electroencephalogram and evoked potential techniques for amelioration of postoperative delirium and cognitive dysfunction following non-cardiac and non neurosurgical procedures in adults. Cochrane Database of Systematic Reviews, n. 5, CD011283, 2018. DOI: https://doi.org/10.1002/14651858.CD011283.pub2.
7. SHORT, T. G. et al. Anaesthetic depth and complications after major surgery: an international, randomised controlled trial. The Lancet, v. 394, n. 10212, p. 1907-1914, 2019. DOI: https://doi.org/10.1016/S0140-6736(19)32350-3.
8. SUMNER, M. et al. Processed electroencephalography-guided general anaesthesia to reduce postoperative delirium: a systematic review and meta-analysis. British Journal of Anaesthesia, v. 130, n. 2, p. e243-e253, 2023. DOI: https://doi.org/10.1016/j.bja.2022.01.006.
9. WILDES, T. S. et al. Effect of electroencephalography-guided anesthetic administration on postoperative delirium among older adults undergoing major surgery: the ENGAGES randomized clinical trial. JAMA, v. 321, n. 5, p. 473-483, 2019. DOI: https://doi.org/10.1001/jama.2018.22005.
10. SUN, Y. et al. Electroencephalography-guided anesthetic delivery for preventing postoperative delirium in adults: an updated meta-analysis. Anesthesia & Analgesia, v. 131, n. 3, p. 712-719, 2020. DOI: https://doi.org/10.1213/ANE.0000000000004746.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Isabela Azambuja Miotto, Samira Fonseca Nogueira Petermann Kyono, Giovana Bondavalli Girotto, Damily Vitoria Valentim Lima
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os artigos publicados na International Journal of Health and Surgical Research são licenciados sob a Creative Commons Attribution 4.0 International (CC BY 4.0).
Isso permite que outros distribuam, remixem, adaptem e criem a partir do trabalho publicado, para qualquer finalidade, incluindo comercial, desde que seja dado o devido crédito ao autor original e à revista.
Os autores mantêm os direitos autorais de seus trabalhos e concedem à revista o direito de primeira publicação.
