ArticleFrontiers in aging neuroscience2025
Influence of anesthetic agent and burst suppression on postoperative delirium in elderly patients: a prospective cohort study with automated EEG analysis.
Article in Frontiers in aging neuroscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Long-Term Cognitive and Functional Outcomes of Anesthesia and Surgery in Patients with Dementia.Healthcare (Basel, Switzerland) · 2026Review
- Ambient Music Decreases EEG Burst-Suppression Ratio During General Anesthesia in Rats.Sensors (Basel, Switzerland) · 2026Article
- The perioperative brain-heart-immune axis: autonomic resilience, multimodal monitoring and postoperative delirium.Frontiers in medicine · 2026Review
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Authors and funding
8 authors.
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Abstract
Background: Guidelines currently suggest considering EEG guidance during general anesthesia in elderly patients to avoid prolonged burst suppression (BS), with the aim of mitigating postoperative delirium (POD). Our study aimed to investigate the association between POD and intraoperative BS duration dependent on the general anesthetic agent used (propofol vs. sevoflurane). Methods: In this prospective study (2019-2022), EEGs from 265 patients over 70 years undergoing general anesthesia were analyzed for intraoperative BS duration both visually and using one new automated algorithm to evaluate its accuracy. Associations between BS duration, anesthetic agent, and postoperative delirium (POD) were evaluated using multivariable logistic regression, adjusting for confounders. Results: BS duration was markedly shorter than in prior cohorts but did not reduce overall postoperative delirium (POD) incidence. POD occurred more frequently with sevoflurane than propofol (44% vs. 30%, Conclusion: Sevoflurane markedly increased POD risk versus propofol, independent of BS duration. Sevoflurane and BS interaction amplified delirium odds. BS appears a vulnerability marker rather than a causal factor. The validated machine-learning BS detector offers a reliable tool for future EEG-based delirium risk research.
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