Desflurane is risk factor for postoperative delirium in older patients’ independent from intraoperative burst suppression duration

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dc.contributor.authorKoch, Susanne
dc.contributor.authorBlankertz, Benjamin
dc.contributor.authorWindmann, Victoria
dc.contributor.authorSpies, Claudia
dc.contributor.authorRadtke, Finn M.
dc.contributor.authorRöhr, Vera
dc.date.accessioned2023-03-17T11:55:13Z
dc.date.available2023-03-17T11:55:13Z
dc.date.issued2023-02-01
dc.date.updated2023-02-15T08:48:19Z
dc.description.abstractBackground: Postoperative Delirium (POD) is the most frequent neurocognitive complication after general anesthesia in older patients. The development of POD is associated with prolonged periods of burst suppression activity in the intraoperative electroencephalogram (EEG). The risk to present burst suppression activity depends not only on the age of the patient but is also more frequent during propofol anesthesia as compared to inhalative anesthesia. The aim of our study is to determine, if the risk to develop POD differs depending on the anesthetic agent given and if this correlates with a longer duration of intraoperative burst suppression. Methods: In this secondary analysis of the SuDoCo trail [ISRCTN 36437985] 1277 patients, older than 60 years undergoing general anesthesia were included. We preprocessed and analyzed the raw EEG files from each patient and evaluated the intraoperative burst suppression duration. In a logistic regression analysis, we assessed the impact of burst suppression duration and anesthetic agent used for maintenance on the risk to develop POD. Results: 18.7% of patients developed POD. Burst suppression duration was prolonged in POD patients (POD 27.5 min ± 21.3 min vs. NoPOD 21.4 ± 16.2 min, p < 0.001), for each minute of prolonged intraoperative burst suppression activity the risk to develop POD increased by 1.1% (OR 1.011, CI 95% 1.000–1.022, p =  0.046). Burst suppression duration was prolonged under propofol anesthesia as compared to sevoflurane and desflurane anesthesia (propofol 32.5 ± 20.3 min, sevoflurane 17.1 ± 12.6 min and desflurane 20.1 ± 16.0 min, p < 0.001). However, patients receiving desflurane anesthesia had a 1.8fold higher risk to develop POD, as compared to propofol anesthesia (OR 1.766, CI 95% 1.049–2.974, p =  0.032). Conclusion: We found a significantly increased risk to develop POD after desflurane anesthesia in older patients, even though burst suppression duration was shorter under desflurane anesthesia as compared to propofol anesthesia. Our finding might help to explain some discrepancies in studies analyzing the impact of burst suppression duration and EEG-guided anesthesia on the risk to develop POD.en
dc.description.sponsorshipDFG, 384950143, GRK 2433: Differentialgleichungs- und Daten-basierte Modelle in den Lebenswissenschaften und der Fluiddynamik (DAEDALUS)
dc.identifier.eissn1663-4365
dc.identifier.urihttps://depositonce.tu-berlin.de/handle/11303/18326
dc.identifier.urihttps://doi.org/10.14279/depositonce-17134
dc.language.isoen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subject.ddc600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.subject.otherburst suppression EEG
dc.subject.otherintraoperative EEG monitoring
dc.subject.otherdesflurane anesthesia
dc.subject.otherpropofol anesthesia
dc.subject.otherelderly
dc.subject.otherpostoperative delirium
dc.titleDesflurane is risk factor for postoperative delirium in older patients’ independent from intraoperative burst suppression duration
dc.typeArticle
dc.type.versionpublishedVersion
dcterms.bibliographicCitation.articlenumber1067268
dcterms.bibliographicCitation.doi10.3389/fnagi.2023.1067268
dcterms.bibliographicCitation.journaltitleFrontiers in Aging Neuroscience
dcterms.bibliographicCitation.originalpublishernameFrontiers
dcterms.bibliographicCitation.originalpublisherplaceLausanne
dcterms.bibliographicCitation.volume15
dcterms.rightsHolder.referenceCreative-Commons-Lizenz
tub.accessrights.dnbfree
tub.affiliationFak. 4 Elektrotechnik und Informatik::Inst. Softwaretechnik und Theoretische Informatik::FG Neurotechnologie
tub.publisher.universityorinstitutionTechnische Universität Berlin

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