Monitoring Brain Health and Anesthesia for Elderly Patients-Monitoring, Brain Health, and Anesthesia for Elderly Patients

Video Transcription

Video Summary

The session, led by Dee Bender, focused on neurocognitive disorders related to anesthesia, particularly in frail and elderly patients. Bender provided essential reminders, such as downloading the AANA Meetings app for bios, presentation slides, and CE claiming until September 9th. The primary discussion, introduced by Dr. Brett Morgan, Dr. Zahn Sentamal, and Ph.D. candidate Rhea Timmerman, explored the relationship between anesthesia and brain health.<br /><br />Key topics included the identification and differentiation of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). POD is characterized by acute onset, with symptoms like disorientation and memory impairment occurring within hours or days post-surgery, increasing mortality rates significantly. POCD, more subtle and long-term, affects memory and executive functions, with symptoms manifesting weeks or even months post-surgery.<br /><br />The session highlighted the crucial role of neuroinflammatory processes in these conditions, emphasizing the activation of microglia and subsequent neuroinflammation from surgical tissue injury. Research established that anesthesia depth significantly impacts cognitive outcomes, stressing the importance of avoiding burst suppression through careful anesthetic management.<br /><br />The presentation advocated for using tools like the BIS Monitor for process EEG to titrate anesthesia accurately, enhancing recovery while potentially reducing the incidents of POD and POCD. Practical strategies discussed included prehabilitation, maintaining adequate hydration, and specific pharmacological interventions like dexmedetomidine infusion for its neuroprotective properties.<br /><br />The discussion concluded by acknowledging current evidence's variability due to methodological differences, encouraging a comprehensive approach to monitoring and managing anesthesia depth to mitigate neurocognitive risks in susceptible patient populations. The session invited audience engagement and addressed questions, ultimately providing a richer understanding of anesthesia-related neurocognitive health.

Keywords

neurocognitive disorders

anesthesia

frail patients

elderly patients

postoperative delirium

postoperative cognitive dysfunction

neuroinflammation

BIS Monitor

dexmedetomidine

anesthesia depth