Department of Anesthesiology.
Department of Neurology.
Br J Anaesth. 2017 Aug 1;119(2):294-307. doi: 10.1093/bja/aew475.
Delirium commonly manifests in the postoperative period as a clinical syndrome resulting from acute brain dysfunction or encephalopathy. Delirium is characterized by acute and often fluctuating changes in attention and cognition. Emergence delirium typically presents and resolves within minutes to hours after termination of general anaesthesia. Postoperative delirium hours to days after an invasive procedure can herald poor outcomes. Easily recognized when patients are hyperactive or agitated, delirium often evades diagnosis as it most frequently presents with hypoactivity and somnolence. EEG offers objective measurements to complement clinical assessment of this complex fluctuating disorder. Although EEG features of delirium in the postoperative period remain incompletely characterized, a shift of EEG power into low frequencies is a typical finding shared among encephalopathies that manifest with delirium. In aggregate, existing data suggest that serial or continuous EEG in the postoperative period facilitates monitoring of delirium development and severity and assists in detecting epileptic aetiologies. Future studies are needed to clarify the precise EEG features that can reliably predict or diagnose delirium in the postoperative period, and to provide mechanistic insights into this pathologically diverse neurological disorder.
谵妄通常在术后表现为一种急性脑功能障碍或脑病引起的临床综合征。谵妄的特征是注意力和认知的急性和经常波动的变化。苏醒性谵妄通常在全身麻醉终止后几分钟到几小时内出现并解决。侵入性手术后数小时至数天出现的术后谵妄可能预示着不良结局。当患者表现出过度活跃或激动时，谵妄很容易被识别，但它通常表现为活动减少和嗜睡，因此常常被漏诊。脑电图提供了客观的测量方法，以补充对这种复杂波动障碍的临床评估。尽管术后谵妄的脑电图特征仍不完全明确，但脑电图功率向低频转移是一种常见的发现，存在于以谵妄为表现的脑病中。总之，现有数据表明，术后连续或连续脑电图有助于监测谵妄的发展和严重程度，并有助于检测癫痫病因。需要进一步的研究来阐明能够可靠地预测或诊断术后谵妄的精确脑电图特征，并深入了解这种病理多样性的神经障碍。
