Intraoperative Electroencephalography Alpha-Band Power Is a Better Proxy for Preoperative Low MoCA Under Propofol Compared With Sevoflurane.

Autor:	Guessous K; From the AP-HP, Hôpital Lariboisière, Paris, France.; Sorbonne Université, Paris, France.; UMR-942, Inserm Délégation Régionale Paris 7, Bagnolet, France., Touchard C; From the AP-HP, Hôpital Lariboisière, Paris, France.; Université Paris Cité, Boulogne-Billancourt, France., Glezerson B; The Montréal Neurological Institute and Hospital, McGill University, Montréal, Canada., Levé C; From the AP-HP, Hôpital Lariboisière, Paris, France.; Université Paris Cité, Boulogne-Billancourt, France., Sabbagh D; Université Paris-Saclay, Inria, CEA, Palaiseau, France., Mebazaa A; From the AP-HP, Hôpital Lariboisière, Paris, France.; UMR-942, Inserm Délégation Régionale Paris 7, Bagnolet, France.; Université Paris Cité, Boulogne-Billancourt, France., Gayat E; Sorbonne Université, Paris, France.; UMR-942, Inserm Délégation Régionale Paris 7, Bagnolet, France.; Université Paris Cité, Boulogne-Billancourt, France., Paquet C; Cognitive Neurology Center, Memory department, Saint-Louis Lariboisière-Fernand Widal Hospital, APHP, Université Paris Cité INSERU1144, France., Vallée F; From the AP-HP, Hôpital Lariboisière, Paris, France.; UMR-942, Inserm Délégation Régionale Paris 7, Bagnolet, France.; Université Paris Cité, Boulogne-Billancourt, France.; Université Paris-Saclay, Inria, CEA, Palaiseau, France., Cartailler J; From the AP-HP, Hôpital Lariboisière, Paris, France.; UMR-942, Inserm Délégation Régionale Paris 7, Bagnolet, France.
Jazyk:	angličtina
Zdroj:	Anesthesia and analgesia [Anesth Analg] 2023 Nov 01; Vol. 137 (5), pp. 1084-1092. Date of Electronic Publication: 2023 Apr 04.
DOI:	10.1213/ANE.0000000000006422
Abstrakt:	Background: Preoperative abnormal cognitive status is a risk factor for postoperative complications yet remains underdiagnosed. During propofol general anesthesia, intraoperative electroencephalography (EEG) variables, such as alpha band power (α-BP), correlate with cognitive status. This relationship under sevoflurane is unclear. We investigated whether EEG biomarkers of poor cognitive status found under propofol could be extended to sevoflurane. Methods: In this monocentric prospective observational study, 106 patients with intraoperative EEG monitoring were included (propofol/sevoflurane = 55/51). We administered the Montreal Cognitive Assessment (MoCA) scale to identify abnormal cognition (low MoCA) 1 day before intervention. EEG variables included delta to beta frequency band powers. Results were adjusted to age and drug dosage. We assessed depth of anesthesia (DoA) using the spectral edge frequency (SEF 95 ) and maintained it within (8-13) Hz. Results: The difference in α-BP between low and normal MoCA patients was significantly larger among propofol patients (propofol: 4.3 ± 4.8 dB versus sevoflurane: 1.5 ± 3.4 dB, P = .022). SEF 95 and age were not statistically different between sevoflurane and propofol groups. After adjusting to age and dose, low α-BP was significantly associated with low MoCA under propofol (odds ratio [OR] [confidence interval {CI}] = 0.39 [0.16-0.94], P = .034), but not under sevoflurane, where theta-band power was significantly associated with low MoCA (OR [CI] = 0.31 [0.13-0.73], P = .007). Conclusions: We suggest that intraoperative EEG biomarkers of abnormal cognition differ between propofol and sevoflurane under general anesthesia. Competing Interests: Conflicts of Interest: See Disclosures at the end of the article. (Copyright © 2023 International Anesthesia Research Society.)
Databáze:	MEDLINE
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