118864 20240319081024.0 doi 10.1038/s41598-022-16466-y sideral 130279 ART-2022-130279 eng Pérez-Otal, Berta Neuromonitoring depth of anesthesia and its association with postoperative delirium 2022 Access copy available to the general public Unrestricted Delirium after surgery or Postoperative delirium (POD) is an underdiagnosed entity, despite its severity and high incidence. Patients with delirium require a longer hospital stay and present more postoperative complications, which also increases hospital costs. Given its importance and the lack of specific treatment, multifactorial preventive strategies are evidenced based. Our hypothesis is that using general anaesthesia and avoiding the maximum time in excessively deep anaesthetic planes through BIS neuromonitoring device will reduce the incidence of postoperative delirium in patients over the age of 65 and their hospitalization stay. Patients were randomly assigned to two groups: The visible BIS group and the hidden BIS neuromonitoring group. In the visible BIS group, the depth of anaesthesia was sustained between 40 and 60, while in the other group the depth of anaesthesia was guided by hemodynamic parameters and the Minimum Alveolar Concentration value. Patients were assessed three times a day by research staff fully trained during the 72 h after the surgery to determine the presence of POD, and there was follow-up at 30 days. Patients who developed delirium (n = 69) was significantly lower in the visible BIS group (n = 27; 39.1%) than in the hidden BIS group (n = 42, 60.9%; p = 0.043). There were no differences between the subtypes of delirium in the two groups. Patients in the hidden BIS group were kept for 26.6 ± 14.0 min in BIS values < 40 versus 11.6 ± 10.9 min (p < 0.001) for the patients in the visible BIS group. The hospital stay was lower in the visible BIS group 6.56 ± 6.14 days versus the 9.30 ± 7.11 days (p < 0.001) for the hidden BIS group, as well as mortality; hidden BIS 5.80% versus visible BIS 0% (p = 0.01). A BIS-guided depth of anaesthesia is associated with a lower incidence of delirium. Patients with intraoperative neuromonitoring stayed for a shorter time in excessively deep anaesthetic planes and presented a reduction in hospital stay and mortality. info:eu-repo/semantics/openAccess by http://creativecommons.org/licenses/by/3.0/es/ 4.6 2022 MULTIDISCIPLINARY SCIENCES 22 / 73 = 0.301 2022 Q2 T1 0.973 2022 Multidisciplinary 2022 Q1 7.5 2022 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Aragón-Benedí, Cristian Universidad de Zaragoza Pascual-Bellosta, Ana Universidad de Zaragoza (orcid)0000-0001-9440-8282 Ortega-Lucea, Sonia Universidad de Zaragoza (orcid)0000-0002-2378-8668 Martínez-Ubieto, Javier Universidad de Zaragoza (orcid)0000-0003-2462-1904 Ramírez-Rodríguez, J.M. Universidad de Zaragoza (orcid)0000-0001-7964-1166 Quesada-Gimeno, Natividad Universidad de Zaragoza Muñoz-Rodríguez, Luis Alfonso Universidad de Zaragoza (orcid)0000-0003-1174-0525 Jiménez-Bernadó, Teresa Universidad de Zaragoza (orcid)0000-0002-6314-551X Pérez-Navarro, Guillermo Lucas-Luesma, Alejandro (orcid)0000-0002-4567-942X Carbó-Espinosa, Fernando Hormigón-Ausejo, Mariana Ojeda-Cabrera, Jorge Luis Universidad de Zaragoza (orcid)0000-0003-0853-2880 2007 265 Universidad de Zaragoza Dpto. Métodos Estadísticos Área Estadís. Investig. Opera. 1006 255 Universidad de Zaragoza Dpto. Fisiatría y Enfermería Área Enfermería 1013 090 Universidad de Zaragoza Dpto. Cirugía Área Cirugía 12 (2022), 12703 [9 pp.] Sci. rep. (Nat. Publ. Group) Scientific reports (Nature Publishing Group) 2045-2322 1156938 http://zaguan.unizar.es/record/118864/files/texto_completo.pdf Versión publicada 2514763 http://zaguan.unizar.es/record/118864/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:118864 articulos driver 2024-03-18-16:33:58 ARTICLE