SynthesisPloS one2020
Is the bispectral index monitoring protective against postoperative cognitive decline? A systematic review with meta-analysis.
Synthesis in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06685770 (THE EFFECT OF PEROPERATIVE TOTAL INTRAVENOUS ANESTHESIA AND INHALER ANESTHESIA ON POSTOPERATIVE NEUROCGNITIVE DISORDER IN BREAST CANCER SURGERY), which is not on this map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The effect of peroperative total intravenous anesthesia and inhaler anesthesia on postoperative neurocgnitive disorder in breast cancer surgery
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Electroencephalography Monitoring for Preventing Postoperative Delirium and Postoperative Cognitive Decline in Patients Undergoing Cardiothoracic Surgery: A Meta-Analysis.Reviews in cardiovascular medicine · 2024Pooled it
- Index of consciousness monitoring during general anesthesia may effectively enhance rehabilitation in elderly patients undergoing laparoscopic urological surgery: a randomized controlled clinical trial.BMC anesthesiology · 2023Trial
- Effect of Preoperative Oral Saline Administration on Postoperative Delirium in Older Persons: A Randomized Controlled Trial.Clinical interventions in aging · 2022Trial
- Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia.Computational and mathematical methods in medicine · 2022Trial
- Depth of anesthesia monitoring: Current evidence, clinical impact, and future directions.The Journal of international medical research · 2026Review
- [Special considerations in geriatric anesthesiology : Aspects of perioperative management in older adults].Zeitschrift fur Gerontologie und Geriatrie · 2026Review
- Comparison of bispectral index and patient state index during general anesthesia with remimazolam.BMC anesthesiology · 2025Article
- Influence of different anesthetic depth on postoperative delirium in elderly pre-frail patients undergoing abdominal surgery.Perioperative medicine (London, England) · 2025Article
- [Special considerations in geriatric anesthesiology : Aspects of perioperative management in older adults].Die Anaesthesiologie · 2025Review
- Electroencephalogram monitoring during anesthesia and critical care: a guide for the clinician.Journal of clinical monitoring and computing · 2025Review
- Anesthesia-related factors in the pathogenesis of postoperative cognitive dysfunction: a mechanistic perspective.Frontiers in neurology · 2025Article
- Mechanism of cognitive impairment after laparoscopic surgery and nursing application progress based on EEG monitoring.Frontiers in neurology · 2025Review
- Bispectral index monitoring: Optimizing anesthesia in rigid bronchoscopy.Tuberkuloz ve toraks · 2024Article
- Postoperative cognitive dysfunction: a concept analysis.Aging clinical and experimental research · 2024Review
- Knowledge, attitudes, and practice toward postoperative cognitive dysfunction among anesthesiologists in China: a cross-sectional study.BMC medical education · 2024Article
- Association between anaesthesia-related factors and postoperative neurocognitive disorder: a post-hoc analysis.BMC anesthesiology · 2023Observational
- The Impact of Rocuronium and Sugammadex on Length of Stay in Patients Undergoing Open Spine Surgery: A Propensity Score-Matched Analysis.Bioengineering (Basel, Switzerland) · 2023Article
- Density Spectral Array Enables Precise Sedation Control for Supermicrosurgical Lymphaticovenous Anastomosis: A Retrospective Observational Cohort Study.Bioengineering (Basel, Switzerland) · 2023Article
- Review
- Perioperative neurocognitive disorders: A narrative review focusing on diagnosis, prevention, and treatment.CNS neuroscience & therapeutics · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral studies have suggested that monitoring the depth of anaesthesia might prevent the development of postoperative cognitive decline. We aimed to conduct a meta-analysis to investigate the effects of bispectral index (BIS) monitoring in anaesthesia.
methodsWe searched in six major electronic databases. Trials were included if they discussed anaesthesia with and without BIS monitoring or low (<50) and high (≥50) BIS levels and which measured the risk of postoperative delirium (POD) and/or postoperative cognitive dysfunction (POCD).
resultsWe included fourteen studies in the systematic review, eight of which were eligible for meta-analysis. BIS proved to be protective against POD at 1 day postoperatively in a cohort of 2138 patients (16.1% vs. 22.8% for BIS vs. no BIS groups, respectively; relative risk [RR] 0.71; 95% confidence interval [CI] 0.59 to 0.85, without significant between-study heterogeneity I2 = 0.0%, P = 0.590). The use of BIS was neutral for POCD at 1 week but protective for POCD at 12 weeks (15.8% vs. 18.8% for BIS vs. no BIS groups, respectively; RR = 0.84, CI: 0.66 to 1.08), without significant between-study heterogeneity (I2 = 25.8%, P = 0.260). The neutral association at 1 week proved to be underpowered with trial sequential analysis. In the comparison of low BIS versus high BIS, the incidence of POD at 1 day was similar in the groups.
conclusionOur findings suggest a protective effect of BIS compared to not using BIS regarding the incidence of POD at 1 day and POCD at 12 weeks. However, limitations of the evidence warrant further investigation to identify those groups of patients by age, comorbid conditions and other individual variables who would benefit the most from the use of BIS monitoring.
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What OpenQuestion holds
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.