Department of Anesthesiology, The 1st Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Anesthesiology, The 1st Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
World Neurosurg. 2021 Mar;147:e57-e62. doi: 10.1016/j.wneu.2020.11.110. Epub 2020 Dec 9.
Postoperative delirium (POD) is a form of delirium that affects patients who have undergone surgical procedures and anesthesia, usually peaking between 1 and 3 days after their operation. The aim of this meta-analysis was to determine whether monitoring of depth of anesthesia may influence the incidence of POD.
A systematic literature search was conducted on studies that reported POD in elderly patients (>60 years old) who underwent surgery. This meta-analysis was carried out using random-effects model.
Compared with control group, intraoperative bispectral index (BIS) monitoring reduced POD (odds ratio 1.32, 95% confidence interval 1.11-1.57, P = 0.001, I = 51%). In the mixed-surgery group, compared with the control group, BIS monitoring decreased the incidence of POD (odds ratio 1.24, 95% confidence interval 1.07-1.44, P = 0.004, I = 61%). There was also no significant difference in the incidence of POD among patients who underwent cardiac, colon, and orthopedic surgeries.
BIS monitoring during surgery can reduce the incidence of POD in elderly patients. Whether BIS monitoring may reduce the incidence of POD in a single type of surgery needs further study.
术后谵妄（POD）是一种影响接受手术和麻醉的患者的谵妄形式，通常在手术后 1 至 3 天达到高峰。本荟萃分析旨在确定麻醉深度监测是否会影响 POD 的发生率。
对报告了接受手术的老年患者（>60 岁）发生 POD 的研究进行了系统文献检索。本荟萃分析使用随机效应模型进行。
与对照组相比，术中双频谱指数（BIS）监测降低了 POD 的发生率（比值比 1.32，95%置信区间 1.11-1.57，P=0.001，I=51%）。在混合手术组中，与对照组相比，BIS 监测降低了 POD 的发生率（比值比 1.24，95%置信区间 1.07-1.44，P=0.004，I=61%）。在接受心脏、结肠和骨科手术的患者中，POD 的发生率也没有差异。
术中 BIS 监测可降低老年患者 POD 的发生率。BIS 监测是否可降低单一类型手术中 POD 的发生率需要进一步研究。
