Matches in SemOpenAlex for { <https://semopenalex.org/work/W2912852742> ?p ?o ?g. }
- W2912852742 endingPage "473" @default.
- W2912852742 startingPage "473" @default.
- W2912852742 abstract "<h3>Importance</h3> Intraoperative electroencephalogram (EEG) waveform suppression, often suggesting excessive general anesthesia, has been associated with postoperative delirium. <h3>Objective</h3> To assess whether EEG-guided anesthetic administration decreases the incidence of postoperative delirium. <h3>Design, Setting, and Participants</h3> Randomized clinical trial of 1232 adults aged 60 years and older undergoing major surgery and receiving general anesthesia at Barnes-Jewish Hospital in St Louis. Recruitment was from January 2015 to May 2018, with follow-up until July 2018. <h3>Interventions</h3> Patients were randomized 1:1 (stratified by cardiac vs noncardiac surgery and positive vs negative recent fall history) to receive EEG-guided anesthetic administration (n = 614) or usual anesthetic care (n = 618). <h3>Main Outcomes and Measures</h3> The primary outcome was incident delirium during postoperative days 1 through 5. Intraoperative measures included anesthetic concentration, EEG suppression, and hypotension. Adverse events included undesirable intraoperative movement, intraoperative awareness with recall, postoperative nausea and vomiting, medical complications, and death. <h3>Results</h3> Of the 1232 randomized patients (median age, 69 years [range, 60 to 95]; 563 women [45.7%]), 1213 (98.5%) were assessed for the primary outcome. Delirium during postoperative days 1 to 5 occurred in 157 of 604 patients (26.0%) in the guided group and 140 of 609 patients (23.0%) in the usual care group (difference, 3.0% [95% CI, −2.0% to 8.0%];<i>P</i> = .22). Median end-tidal volatile anesthetic concentration was significantly lower in the guided group than the usual care group (0.69 vs 0.80 minimum alveolar concentration; difference, −0.11 [95% CI, −0.13 to −0.10), and median cumulative time with EEG suppression was significantly less (7 vs 13 minutes; difference, −6.0 [95% CI, −9.9 to −2.1]). There was no significant difference between groups in the median cumulative time with mean arterial pressure below 60 mm Hg (7 vs 7 minutes; difference, 0.0 [95% CI, −1.7 to 1.7]). Undesirable movement occurred in 137 patients (22.3%) in the guided and 95 (15.4%) in the usual care group. No patients reported intraoperative awareness. Postoperative nausea and vomiting was reported in 48 patients (7.8%) in the guided and 55 patients (8.9%) in the usual care group. Serious adverse events were reported in 124 patients (20.2%) in the guided and 130 (21.0%) in the usual care group. Within 30 days of surgery, 4 patients (0.65%) in the guided group and 19 (3.07%) in the usual care group died. <h3>Conclusions and Relevance</h3> Among older adults undergoing major surgery, EEG-guided anesthetic administration, compared with usual care, did not decrease the incidence of postoperative delirium. This finding does not support the use of EEG-guided anesthetic administration for this indication. <h3>Trial Registration</h3> ClinicalTrials.gov Identifier:NCT02241655" @default.
- W2912852742 created "2019-02-21" @default.
- W2912852742 creator A5001965534 @default.
- W2912852742 creator A5005229925 @default.
- W2912852742 creator A5007069562 @default.
- W2912852742 creator A5007589744 @default.
- W2912852742 creator A5011090328 @default.
- W2912852742 creator A5013545249 @default.
- W2912852742 creator A5016451996 @default.
- W2912852742 creator A5017516775 @default.
- W2912852742 creator A5018134087 @default.
- W2912852742 creator A5026485862 @default.
- W2912852742 creator A5030522734 @default.
- W2912852742 creator A5032986964 @default.
- W2912852742 creator A5035798548 @default.
- W2912852742 creator A5041901994 @default.
- W2912852742 creator A5041965106 @default.
- W2912852742 creator A5052765780 @default.
- W2912852742 creator A5053095971 @default.
- W2912852742 creator A5053455238 @default.
- W2912852742 creator A5073226199 @default.
- W2912852742 creator A5074807366 @default.
- W2912852742 creator A5075501653 @default.
- W2912852742 creator A5079821576 @default.
- W2912852742 creator A5081462518 @default.
- W2912852742 creator A5086656188 @default.
- W2912852742 date "2019-02-05" @default.
- W2912852742 modified "2023-10-17" @default.
- W2912852742 title "Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery" @default.
- W2912852742 cites W1970588407 @default.
- W2912852742 cites W1988881714 @default.
- W2912852742 cites W2008440727 @default.
- W2912852742 cites W2016967960 @default.
- W2912852742 cites W2076412231 @default.
- W2912852742 cites W2078128988 @default.
- W2912852742 cites W2081033553 @default.
- W2912852742 cites W2083333713 @default.
- W2912852742 cites W2122014319 @default.
- W2912852742 cites W2138141660 @default.
- W2912852742 cites W2141710162 @default.
- W2912852742 cites W2149049531 @default.
- W2912852742 cites W2156100110 @default.
- W2912852742 cites W2166637321 @default.
- W2912852742 cites W2167165853 @default.
- W2912852742 cites W2255398506 @default.
- W2912852742 cites W2284934144 @default.
- W2912852742 cites W2287468409 @default.
- W2912852742 cites W2398905005 @default.
- W2912852742 cites W2437361581 @default.
- W2912852742 cites W2473347715 @default.
- W2912852742 cites W2473477790 @default.
- W2912852742 cites W2513726587 @default.
- W2912852742 cites W2570543628 @default.
- W2912852742 cites W2581138085 @default.
- W2912852742 cites W2586426771 @default.
- W2912852742 cites W2592573234 @default.
- W2912852742 cites W2613056867 @default.
- W2912852742 cites W2620353503 @default.
- W2912852742 cites W2706104770 @default.
- W2912852742 cites W2772621573 @default.
- W2912852742 cites W2782858624 @default.
- W2912852742 cites W2803666327 @default.
- W2912852742 cites W2804416427 @default.
- W2912852742 cites W2808314891 @default.
- W2912852742 cites W2901202630 @default.
- W2912852742 cites W4238837252 @default.
- W2912852742 doi "https://doi.org/10.1001/jama.2018.22005" @default.
- W2912852742 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/6439616" @default.
- W2912852742 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/30721296" @default.
- W2912852742 hasPublicationYear "2019" @default.
- W2912852742 type Work @default.
- W2912852742 sameAs 2912852742 @default.
- W2912852742 citedByCount "263" @default.
- W2912852742 countsByYear W29128527422019 @default.
- W2912852742 countsByYear W29128527422020 @default.
- W2912852742 countsByYear W29128527422021 @default.
- W2912852742 countsByYear W29128527422022 @default.
- W2912852742 countsByYear W29128527422023 @default.
- W2912852742 crossrefType "journal-article" @default.
- W2912852742 hasAuthorship W2912852742A5001965534 @default.
- W2912852742 hasAuthorship W2912852742A5005229925 @default.
- W2912852742 hasAuthorship W2912852742A5007069562 @default.
- W2912852742 hasAuthorship W2912852742A5007589744 @default.
- W2912852742 hasAuthorship W2912852742A5011090328 @default.
- W2912852742 hasAuthorship W2912852742A5013545249 @default.
- W2912852742 hasAuthorship W2912852742A5016451996 @default.
- W2912852742 hasAuthorship W2912852742A5017516775 @default.
- W2912852742 hasAuthorship W2912852742A5018134087 @default.
- W2912852742 hasAuthorship W2912852742A5026485862 @default.
- W2912852742 hasAuthorship W2912852742A5030522734 @default.
- W2912852742 hasAuthorship W2912852742A5032986964 @default.
- W2912852742 hasAuthorship W2912852742A5035798548 @default.
- W2912852742 hasAuthorship W2912852742A5041901994 @default.
- W2912852742 hasAuthorship W2912852742A5041965106 @default.
- W2912852742 hasAuthorship W2912852742A5052765780 @default.
- W2912852742 hasAuthorship W2912852742A5053095971 @default.
- W2912852742 hasAuthorship W2912852742A5053455238 @default.
- W2912852742 hasAuthorship W2912852742A5073226199 @default.