NDLI: The effect of anesthetic depth on postoperative delirium in older adults: a systematic review and meta-analysis

Content Provider	Springer Nature : BioMed Central
Author	Wang, Yafeng Zhu, Hongyu Xu, Feng Ding, Yuanyuan Zhao, Shuai Chen, Xiangdong
Abstract	Background Postoperative delirium (POD) is an important complication for older patients and recent randomised controlled trials have showed a conflicting result of the effect of deep and light anesthesia. Methods We included randomised controlled trials including older adults that evaluated the effect of anesthetic depth on postoperative delirium from PubMed, Embase, Web of Science and Cochrane Library. We considered deep anesthesia as observer’s assessment of the alertness/ sedation scale (OAA/S) of 0–2 or targeted bispectral (BIS) < 45 and the light anesthesia was considered OAA/S 3–5 or targeted BIS > 50. The primary outcome was incidence of POD within 7 days after surgery. And the secondary outcomes were mortality and cognitive function 3 months or more after surgery. The quality of evidence was assessed via the grading of recommendations assessment, development, and evaluation approach. Results We included 6 studies represented 7736 patients aged 60 years and older. We observed that the deep anesthesia would not increase incidence of POD when compared with the light anesthesia when 4 related studies were pooled (OR, 1.40; 95% CI, 0.63–3.08, P = 0.41, I2 = 82%, low certainty). And no significant was found in mortality (OR, 1.12; 95% CI, 0.93–1.35, P = 0.23, I2 = 0%, high certainty) and cognitive function (OR, 1.13; 95% CI, 0.67–1.91, P = 0.64, I2 = 13%, high certainty) 3 months or more after surgery between deep anesthesia and light anesthesia. Conclusions Low-quality evidence suggests that light general anesthesia was not associated with lower POD incidence than deep general anesthesia. And High-quality evidence showed that anesthetic depth did not affect the long-term mortality and cognitive function. Systematic review registration CRD42022300829 (PROSPERO).
Related Links	https://bmcgeriatr.biomedcentral.com/counter/pdf/10.1186/s12877-023-04432-w.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14712318
DOI	10.1186/s12877-023-04432-w
Journal	BMC Geriatrics
Issue Number	1
Volume Number	23
Language	English
Publisher	BioMed Central
Publisher Date	2023-11-06
Access Restriction	Open
Subject Keyword	Geriatrics Gerontology Aging Rehabilitation Anesthetic depth Postoperative delirium Older adults General anesthesia BIS Geriatrics/Gerontology
Content Type	Text
Resource Type	Article
Subject	Geriatrics and Gerontology
Journal Impact Factor	3.4/2023
5-Year Journal Impact Factor	4.1/2023

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