Observational studyAnesthesia and analgesia2021
Association Between Lower Preoperative Cognition With Intraoperative Electroencephalographic Features Consistent With Deep States of Anesthesia in Older Patients: An Observational Cohort Study.
Observational study in Anesthesia and analgesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07254975 (An Observational Prospective Study of Anesthetic Sensitivity Assessed by Alpha Band Power and Its Association With Emergence Time From Sevoflurane General Anesthesia in Young Adults.), which is not on this map. Cited by 11 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.
An Observational Prospective Study of Anesthetic Sensitivity Assessed by Alpha Band Power and Its Association With Emergence Time From Sevoflurane General Anesthesia in Young Adults.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Use of Near-Infrared Spectroscopy and/or Transcranial Doppler as Non-Invasive Markers of Cerebral Perfusion in Adult Sepsis Patients With Delirium: A Systematic Review.Journal of intensive care medicine · 2022Pooled it
- The Association of Preoperative Cognitive Dysfunction to Common Intraoperative Electroencephalographic Parameters and Cerebral Hypoxia During Cardiac Surgery.Anesthesia and analgesia · 2026Trial
- Anesthesia-induced electroencephalogram oscillations and perioperative outcomes in older adults undergoing cardiac surgery.Journal of clinical anesthesia · 2025Trial
- A Prospective Study Characterizing Cognitive Function in Patients With Inflammatory Bowel Disease.Clinical and translational gastroenterology · 2026Article
- Comparison of electroencephalogram waveforms in older patients with/without dementia after administration of midazolam: a prospective, observational comparative study.Journal of dental anesthesia and pain medicine · 2026Article
- Preoperative cognitive impairment predicts deep anaesthesia and higher postoperative pain in elderly patients: an observational study.BMC anesthesiology · 2025Observational
- Mechanism of cognitive impairment after laparoscopic surgery and nursing application progress based on EEG monitoring.Frontiers in neurology · 2025Review
- Linear thinking does not reflect the newer 21st-century anesthesia concepts. A narrative review.Journal of clinical monitoring and computing · 2023Review
- Differences in the EEG Power Spectrum and Cross-Frequency Coupling Patterns between Young and Elderly Patients during Sevoflurane Anesthesia.Brain sciences · 2023Article
- Intraoperative electroencephalographic marker of preoperative frailty: A prospective cohort study.Journal of clinical anesthesia · 2023Article
- Electroencephalogram Features of Perioperative Neurocognitive Disorders in Elderly Patients: A Narrative Review of the Clinical Literature.Brain sciences · 2022Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundPatients with low cognitive performance are thought to have a higher risk of postoperative neurocognitive disorders. Here we analyzed the relationship between preoperative cognition and anesthesia-induced brain dynamics. We hypothesized that patients with low cognitive performance would be more sensitive to anesthetics and would show differences in electroencephalogram (EEG) activity consistent with a brain anesthesia overdose.
methodsThis is a retrospective analysis from a previously reported observational study. We evaluated cognitive performance using the Montreal cognitive assessment (MoCA) test. All patients received general anesthesia maintained with sevoflurane or desflurane during elective major abdominal surgery. We analyzed the EEG using spectral, coherence, and phase-amplitude modulation analyses.
resultsPatients were separated into a low MoCA group (<26 points, n = 12) and a high MoCA group (n = 23). There were no differences in baseline EEG, nor end-tidal age-corrected minimum alveolar concentration (MACage). However, under anesthesia, the low MoCA group had lower α-β power (high MoCA: 2.9 [interquartile range {IQR}: 0.6-5.8 dB] versus low MoCA: -1.2 [IQR: -2.1 to 0.6 dB], difference 4.1 [1.0-5.7]) and a lower α peak frequency (high MoCA: 9.0 [IQR: 8.3-9.8 Hz] versus low MoCA: 7.5 [IQR: 6.3-9.0 Hz], difference 1.5 [0-2.3]) compared to the high MoCA group. The low MoCA group also had a lower α band coherence and a stronger peak-max phase-amplitude coupling (PAC). Finally, patients in the low MoCA group had longer emergence times (high MoCA 663 ± 345 seconds versus low MoCA: 960 ± 352 seconds, difference 297 [15-578]). Multiple linear regression shows up that both age and MoCA scores are independently associated with intraoperative α-β power.
conclusionsAll these EEG features, together with a prolonged emergence time, are consistent with the possibility that older patients with low cognitive performance are receiving a brain anesthesia overdose compare to cognitive normal patients.
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