ArticleBritish journal of anaesthesia2018
Intraoperative electroencephalogram suppression at lower volatile anaesthetic concentrations predicts postoperative delirium occurring in the intensive care unit.
Article in British journal of anaesthesia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04713644 (Study of the Association Between Burst Suppression During Anesthetic Induction With Propofol in Cardiac Surgery in Patients Over 65 Years of Age With Postoperative Delirium), which is not on this map. Cited by 57 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Study of the Association Between Burst Suppression During Anesthetic Induction With Propofol in Cardiac Surgery in Patients Over 65 Years of Age With Postoperative Delirium
Who cites it
57 citing papers in PubMed, 1 synthesis or guideline pooled it, 113 citations in OpenAlex.
- Investigating how electroencephalogram measures associate with delirium: A systematic review.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2021Pooled it
- The Association of Preoperative Cognitive Dysfunction to Common Intraoperative Electroencephalographic Parameters and Cerebral Hypoxia During Cardiac Surgery.Anesthesia and analgesia · 2026Trial
- Effect of raw electroencephalogram-guided anesthesia administration on postoperative outcomes in elderly patients undergoing abdominal major surgery: a randomized controlled trial.BMC anesthesiology · 2023Trial
- Preoperative Cognitive Abnormality, Intraoperative Electroencephalogram Suppression, and Postoperative Delirium: A Mediation Analysis.Anesthesiology · 2020Trial
- Trial
- Beyond processed depth targets: frontal EEG patterns, brain vulnerability, and postoperative delirium in older adults.Journal of clinical monitoring and computing · 2026Review
- Consensus document on electroencephalography education in anaesthesiology: defining learning outcomes: A modified four-round Delphi study.European journal of anaesthesiology · 2026Article
- Predicting delirium in critically Ill COVID-19 patients using EEG-derived data: a machine learning approach.GeroScience · 2026Observational
- Association Between Entropy Monitoring, Burst Suppression and Early Postoperative Cognitive Dysfunction in Emergency Surgery: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Precision perioperative AI: from signals, images, and records to applications in anesthesia-a narrative mini-review proposing an operational framework.Frontiers in medicine · 2026Review
- Development of a deep learning-based prediction model for postoperative delirium using intraoperative electroencephalogram in adults.NPJ digital medicine · 2025Article
- Associations between anaesthetic dose-adjusted intraoperative EEG alpha power, processing speed, and postoperative delirium: analysis of data from three prospective studies.British journal of anaesthesia · 2025Article
- Artificial Intelligence-Powered Quality Assurance: Transforming Diagnostics, Surgery, and Patient Care-Innovations, Limitations, and Future Directions.Life (Basel, Switzerland) · 2025Review
- A ketogenic diet decreases sevoflurane-induced burst suppression in rats.Brain research bulletin · 2025Article
- Postoperative sepsis-associated neurocognitive disorder: mechanisms, predictive strategies, and treatment approaches.Frontiers in medicine · 2025Review
- Quantitative electroencephalography predicts postoperative delirium in adult cardiac surgical patients from a prospective observational study.Scientific reports · 2024Observational
- Optimizing anesthesia management based on early identification of electroencephalogram burst suppression risk in non-cardiac surgery patients: a visualized dynamic nomogram.Annals of medicine · 2024Article
- Brain health: A concern for anaesthesiologists and intensivists.European journal of anaesthesiology and intensive care · 2024Review
- Incidence change of postoperative delirium after implementation of processed electroencephalography monitoring during surgery: a retrospective evaluation study.BMC anesthesiology · 2023Article
- Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPostoperative delirium is a common complication associated with increased morbidity and mortality. A recently-reported association between intraoperative electroencephalogram suppression and postoperative delirium might be mediated in some patients by a heightened sensitivity to volatile anaesthetics.
methodsThis retrospective cohort study included 618 elective surgery patients with planned intensive care unit admission, who also received intraoperative electroencephalogram monitoring and had delirium assessments documented in the medical record. Sensitivity to volatile anaesthetics was assessed using a mixed effects model predicting the likelihood of electroencephalogram suppression at each time point based on the current end-tidal anaesthetic concentration. Patients with a random intercept above the population median (electroencephalogram suppression at lower anaesthetic concentrations) were classified as having heightened sensitivity to volatile anaesthetics. Delirium was defined as a positive Confusion Assessment Method for the Intensive Care Unit assessment anytime in the first five postoperative days.
resultsPostoperative delirium was observed in 162 of 618 patients (26%). Patients who experienced electroencephalogram suppression at lower volatile anaesthetic concentrations had a higher incidence of postoperative delirium [109/309 (35%)] than other patients [53/309 (17%)] [unadjusted odds ratio 2.63; 95% confidence interval (CI), 1.81-3.84, P<0.001]. This association remained significant after adjusting for patient characteristics, surgical variables, and duration of electroencephalogram suppression (adjusted odds ratio 2.13; 95% CI 1.24-3.65, P=0.006).
conclusionsThese data support the hypothesis that patients with electroencephalogram suppression at lower volatile anaesthetic concentrations have an increased incidence of postoperative delirium. Such patients appear to exhibit a phenotype of anaesthetic sensitivity, which might predispose them to adverse cognitive outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.