Some retrospective evidence has lent hope to the attractive notion that reducing anesthesia depth by titrating anesthesia to EEG could also reduce delirium in postoperative elderly patients.
In this study, the primary outcome was incident delirium during postoperative days 1 through 5. While anesthesia agent use was less in the guided group, this randomized study found: These findings do not support the use of electroencephalography-guided anesthetic administration for the prevention of postoperative delirium among older adults undergoing major surgery.
There was no difference in hypotension or awareness under anesthesia, other postulated related outcomes. Lower mortality at 30 days did occur in the EEG guided group, but the significance of this secondary outcome is unclear from this study.