Evidence map›Paper›PMID 36192219›Full record

ArticleBritish journal of anaesthesia2023

Sevoflurane dose and postoperative delirium: a prospective cohort analysis.

Jennifer Taylor, Thomas Payne, Cameron Casey, David Kunkel, Maggie Parker, Cameron Rivera, Henrik Zetterberg, Kaj Blennow, Robert A Pearce, Richard C Lennertz and 3 more

2 registry-linked trialsOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of anaesthesia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT01980511 completednot on this map

Detection and Neurological Impact of CerebroVascular Events In Noncardiac Surgery PatIents: A COhort EvaluatioN

TypeobservationalSponsorMcMaster UniversityRan2014 to 2018Enrolled1,116ConditionsCovert Postoperative Stroke
NCT03124303 recruitingnot on this map

Interventions for Postoperative Delirium: Biomarker-3

TypeobservationalSponsorUniversity of Wisconsin, MadisonRan2017 to 2029Enrolled468ConditionsDeliriumArmsHigh Density-Electroencephalogram, Magnetic Resonance Imaging, Blood specimen collection, Pupillometry
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 16 citations in OpenAlex.

  1. Trial
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  4. Article
  5. Review
  6. Inhaled sevoflurane in critically ill COVID-19 patients: A retrospective cohort study.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026
    Article
  7. Article
  8. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 5 countries.

Jennifer TaylorCentral Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia.
Thomas PayneCentral Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia.
Cameron CaseyDepartment of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
David KunkelDepartment of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Maggie ParkerDepartment of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Cameron RiveraDepartment of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Henrik ZetterbergDepartment of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK; UK Dementia Research Institute at UCL, London, UK; Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China.
Kaj BlennowDepartment of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
Robert A PearceDepartment of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Richard C LennertzDepartment of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Tim McCullochCentral Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia.
Amy GaskellDepartment of Anaesthetics, Waikato Hospital, Hamilton, New Zealand.
Robert D SandersCentral Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia. Electronic address: robert.sanders@sydney.edu.au.
University of Wisconsin–Madison · USThe University of Sydney · AUSahlgrenska University Hospital · SEUniversity of Gothenburg · SEWaikato Hospital · NZ

Funding

Clarifying the overlapping pathology of delirium and dementiaR01AG063849 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI Richard C Lennertz, Robert D Sanders · 2019 to 2026
$5.0M
NIA NIH HHS R01 AG063849
6 · The paper itself

Abstract

backgroundRecent trials are conflicting as to whether titration of anaesthetic dose using electroencephalography monitoring reduces postoperative delirium. Titration to anaesthetic dose itself might yield clearer conclusions. We analysed our observational cohort to clarify both dose ranges for trials of anaesthetic dose and biological plausibility of anaesthetic dose influencing delirium.

methodsWe analysed the use of sevoflurane in an ongoing prospective cohort of non-intracranial surgery. Of 167 participants, 118 received sevoflurane and were aged >65 yr. We tested associations between age-adjusted median sevoflurane (AMS) minimum alveolar concentration fraction or area under the sevoflurane time×dose curve (AUC-S) and delirium severity (Delirium Rating Scale-98). Delirium incidence was measured with 3-minute Diagnostic Confusion Assessment Method (3D-CAM) or CAM-ICU. Associations with previously identified delirium biomarkers (interleukin-8, neurofilament light, total tau, or S100B) were tested.

resultsDelirium severity did not correlate with AMS (Spearman's ρ=-0.014, P=0.89) or AUC-S (ρ=0.093, P=0.35), nor did delirium incidence (AMS Wilcoxon P=0.86, AUC-S P=0.78). Further sensitivity analyses including propofol dose also demonstrated no relationship. Linear regression confirmed no association for AMS in unadjusted (log (IRR)=-0.06 P=0.645) or adjusted models (log (IRR)=-0.0454, P=0.735). No association was observed for AUC-S in unadjusted (log (IRR)=0.00, P=0.054) or adjusted models (log (IRR)=0.00, P=0.832). No association of anaesthetic dose with delirium biomarkers was identified (P>0.05).

conclusionSevoflurane dose was not associated with delirium severity or incidence. Other biological mechanisms of delirium, such as inflammation and neuronal injury, appear more plausible than dose of sevoflurane. CLINICAL

trial registrationNCT03124303, NCT01980511.

Indexed as

Anesthetics, InhalationEmergence DeliriumCohort StudiesHumansProspective StudiesSevofluraneAnesthetics, InhalationSevofluraneanaesthesiabiomarkercognitive dysfunctiondeliriumdose dependencypostoperativesevofluranesurgery

Identifiers

PMID36192219
PMCPMC9997074
OpenAlexW4298625434

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.