is an Assistant Professor in the Department of Nurse Anesthesia, Virginia Commonwealth University, Richmond, Virginia. Email:
AANA J. 2023 Apr;91(2):125-129.
Postoperative delirium is a public health and research priority. The International Perioperative Neurotoxicity Working Group recommends baseline cognitive function be assessed for older patients prior to surgery and anesthesia. Perioperative cognitive screening tools trialed in anesthesia are not routinely incorporated into clinical practice related to validity, reliability, or practicality concerns. The ideal perioperative cognitive screening tool would be rapid; easily administrable; valid; reliable; automatically scored; void of language, cultural, and education bias; and cost-efficient. No such tool currently exists. We explored baseline and postoperative neurocognitive characteristics that may help to establish predictive and trend metrics for perioperative neurocognitive assessment in older surgical patients using a novel, Food and Drug Administration-cleared point-of-care electroencephalography device (WAViMed™, Boulder, CO). To our knowledge, our study is the first to assess the device as a perioperative neurocognitive assessment tool. Although an association between P300 auditory-evoked potentials and Montreal Cognitive Assessment scores was not identified, further investigation is warranted given the magnitude of impact that such a device might have on patient outcomes and healthcare costs.
术后谵妄是一个公共卫生和研究重点。国际围手术期神经毒性工作组建议在手术和麻醉前评估老年患者的基线认知功能。由于有效性、可靠性或实用性问题，麻醉中试用的围手术期认知筛查工具尚未常规纳入临床实践。理想的围手术期认知筛查工具应该快速；易于管理；有效；可靠；自动评分；无语言、文化和教育偏见；并且具有成本效益。目前还没有这样的工具。我们使用一种新型的经食品和药物管理局批准的即时脑电设备（WAViMed™，博尔德，CO）探索了可能有助于为老年手术患者围手术期神经认知评估建立预测和趋势指标的基线和术后神经认知特征。据我们所知，我们的研究首次将该设备评估为围手术期神经认知评估工具。尽管 P300 听觉诱发电位与蒙特利尔认知评估评分之间没有关联，但鉴于该设备可能对患者结局和医疗保健成本产生的巨大影响，仍需要进一步研究。
