Da Xiang, Li Xia, Dong Anmin, Chen Li, Ma Youjia, Li Xue
College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia.
Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Neurol. 2025 Aug 28;16:1638282. doi: 10.3389/fneur.2025.1638282. eCollection 2025.
Postoperative delirium is a frequent and severe complication among elderly surgical patients. Electroencephalogram (EEG)-guided anesthesia, which optimizes sedation depth, holds promise for preventing postoperative delirium; however, current research findings remain inconsistent. This meta-analysis incorporates the most recent trials to evaluate the effectiveness of EEG-guided anesthesia in reducing postoperative delirium incidence in older adults.
We conducted a comprehensive literature search of PubMed, the Cochrane Central Register of Controlled Trials, and Embase from their inception to February 1, 2025, to identify eligible studies. This systematic review and meta-analysis aimed to evaluate the effectiveness of electroencephalogram-guided anesthesia in preventing postoperative delirium among elderly surgical patients. Pooled effect estimates for all outcomes were calculated using a random-effects model. The quality and certainty of the evidence were assessed using the GRADE methodology. The primary outcome was the occurrence of postoperative delirium.
Of the 3,151 studies screened, 12 were deemed eligible for inclusion, encompassing a total of 7,441 patients, of whom 3,707 received EEG-guided anesthesia. Compared with standard care, EEG-guided anesthesia demonstrated a beneficial effect in reducing postoperative delirium among elderly patients (RR = 0.76, 95% CI: 0.61-0.96), as well as the incidence of postoperative infections (RR = 0.74, 95% CI: 0.58-0.95). Subgroup analyses revealed no significant interaction based on type of surgery ( = 0.18).
EEG-guided anesthesia is associated with a reduced incidence of postoperative delirium in elderly surgical patients.
术后谵妄是老年外科患者常见且严重的并发症。脑电图（EEG）引导下的麻醉可优化镇静深度，有望预防术后谵妄；然而，目前的研究结果仍不一致。本荟萃分析纳入了最新的试验，以评估EEG引导下的麻醉在降低老年患者术后谵妄发生率方面的有效性。
我们对PubMed、Cochrane对照试验中心注册库和Embase进行了全面的文献检索，检索时间从各数据库建立至2025年2月1日，以确定符合条件的研究。本系统评价和荟萃分析旨在评估脑电图引导下的麻醉在预防老年外科患者术后谵妄方面的有效性。使用随机效应模型计算所有结局的合并效应估计值。采用GRADE方法评估证据的质量和确定性。主要结局是术后谵妄的发生。
在筛选的3151项研究中，12项被认为符合纳入标准，共纳入7441例患者，其中3707例接受了EEG引导下的麻醉。与标准护理相比，EEG引导下的麻醉在降低老年患者术后谵妄发生率（RR = 0.76，95%CI：0.61 - 0.96）以及术后感染发生率（RR = 0.74，95%CI：0.58 - 0.95）方面显示出有益效果。亚组分析显示，基于手术类型不存在显著交互作用（ = 0.18）。
EEG引导下的麻醉与老年外科患者术后谵妄发生率降低相关。
