Is Depth of Anesthesia, as Assessed by the Bispectral Index, Related to Postoperative Cognitive Dysfunction and Recovery?

@article{Farag2006IsDO,
  title={Is Depth of Anesthesia, as Assessed by the Bispectral Index, Related to Postoperative Cognitive Dysfunction and Recovery?},
  author={Ehab Farag and Gordon Chelune and Armin Schubert and Edward J. Mascha},
  journal={Anesthesia \& Analgesia},
  year={2006},
  volume={103},
  pages={633-640}
}
We randomized 74 patients to either a lower Bispectral Index (BIS) regimen (median BIS, 38.9) or a higher BIS regimen (mean BIS, 50.7) during the surgical procedure. Preoperatively and 4–6 wk after surgery, the patients’ cognitive status was assessed with a cognitive test battery consisting of processing speed index, working memory index, and verbal memory index. Processing speed index was 113.7 ± 1.5 (mean ± se) in the lower BIS group versus 107.9 ± 1.4 in the higher BIS group (P = 0.006). No… 
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Is depth of anesthesia, as assessed by the bispectral index, related to postoperative cognitive dysfunction and recovery?
  • C. Royse
  • Psychology
    Anesthesia and analgesia
  • 2007
TLDR
This work reported less postoperative cognitive dysfunction (POCD) in patients who received a greater depth of anesthesia using isoflurane as the maintenance anesthetic, however, it used 3 rather than 10 tests, and used group means rather than tracking individual changes, as their primary method of analysis.
The effect of bispectral index monitoring on cognitive performance following sedation for outpatient colonoscopy: a randomized controlled trial.
TLDR
BIS monitoring among sedated patients was associated with lower propofol use and smaller decline in cognitive performance, and this trial was registered in the Australian New Zealand Clinical Trial Registry.
Is the bispectral index monitoring protective against postoperative cognitive decline? A systematic review with meta-analysis
TLDR
A protective effect of BIS compared to not using BIS regarding the incidence of POD at 1 day and POCD at 12 weeks is suggested, however, limitations of the evidence warrant further investigation to identify those groups of patients by age, comorbid conditions and other individual variables who would benefit the most.
Is there a relationship between intraoperative bispectral index and cognitive impairment after coronary artery surgery?
TLDR
There may be a relationship between POCD and anesthetic depth in patients undergoing CABG, and BIS scores during and after CPB and throughout the surgery were also higher in patients with versus without P OCD three months after surgery.
Bispectral Index Monitoring Improves the Cognitive Function after Desflurane -Anaesthesia in Elderly Patients Undergoing Spine Surgery
TLDR
It was concluded that BIS-targeted desflurane anaesthesia provides faster recovery and improves the cognitive function in the elderly patients after spine surgery.
BIS-guided Anesthesia Decreases Postoperative Delirium and Cognitive Decline
TLDR
BIS-guided anesthesia reduced anesthetic exposure and decreased the risk of POCD at 3 months after surgery, and for every 1000 elderly patients undergoing major surgery, anesthetic delivery titrated to a range of BIS between 40 and 60 would prevent 23 patients from PocD and 83 patients from delirium.
Bispectral Index Monitoring During Anesthesia Promotes Early Postoperative Recovery of Cognitive Function and Reduces Acute Delirium in Elderly Patients with Colon Carcinoma: A Prospective Controlled Study using the Attention Network Test
TLDR
BIS-guided anesthesia was associated with reduced anesthetic exposure, early postoperative recovery of alerting and orienting functions, and reduced postoperative delirium.
Correlation of the depth of anesthesia with POCD (Postoperative Cognitive Dysfunction) [16]
1. Royse C. Is depth of anesthesia, as assessed by the bispectral index, related to postoperative cognitive dysfunction and recovery? Anesth Analg 2007;104:1297. 2. Farag E, Chelune GJ, Schubert A,…
Ambulatory Anesthesia: Whither Thou Goest
TLDR
Correlation of the intraoperative bispectral index score (BIS) with incidence of postoperative cognitive disorders (POCD) in the geriatric population is found to be close to zero.
BIS index monitoring and perioperative neurocognitive disorders in older adults: a systematic review and meta-analysis
TLDR
No definite evidence demonstrated that BIS-guided anesthesia decreased the incidence of POD, DNR and postoperative NCD in older patients, and more homogeneous RCTs assessing the efficacy of BIS monitoring on reducing the occurrence of these perioperative cognitive disorders are needed.
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Is depth of anesthesia, as assessed by the bispectral index, related to postoperative cognitive dysfunction and recovery?
  • C. Royse
  • Psychology
    Anesthesia and analgesia
  • 2007
TLDR
This work reported less postoperative cognitive dysfunction (POCD) in patients who received a greater depth of anesthesia using isoflurane as the maintenance anesthetic, however, it used 3 rather than 10 tests, and used group means rather than tracking individual changes, as their primary method of analysis.
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