The Utility of Bispectral Index (BIS) Monitoring in Anesthesia for Elderly Patients-References

References

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The references listed comprise a comprehensive bibliography of studies focused on postoperative cognitive impairment, primarily in elderly patients undergoing surgery. The studies explore various aspects of postoperative cognitive dysfunction (POCD) and delirium, examining factors such as preoperative cognitive status, anesthesia methods, and intraoperative monitoring techniques.<br /><br />Several key themes emerge from these references:<br /><br />1. **POCD and Delirium in Elderly Patients**:<br />   - Numerous studies (e.g., Weiss et al., 2023; Alalawi & Yasmeen, 2018) investigate the prevalence and risk factors for POCD and postoperative delirium among elderly surgical patients. Preoperative cognitive impairment is frequently identified as a significant predictor.<br /><br />2. **Types of Anesthesia and Cognitive Outcomes**:<br />   - Comparative studies on the effects of different anesthetic agents, specifically desflurane and sevoflurane, demonstrate varying impacts on postoperative cognitive functions (Alalawi & Yasmeen, 2018).<br /><br />3. **Monitoring Techniques**:<br />   - The use of Bispectral Index (BIS) monitoring during anesthesia is linked with improved cognitive outcomes and reduced postoperative delirium (Zhou et al., 2018; Chan et al., 2013). BIS monitoring helps optimize anesthetic depth and potentially mitigates the risk of cognitive decline.<br /><br />4. **Interventional Strategies**:<br />   - Innovative interventions to reduce cognitive impairment include tailored anesthesia protocols and delirium-preventive strategies (Björkelund et al., 2010; Heinrich et al., 2019).<br /><br />5. **Long-term Cognitive Outcomes**:<br />   - Longitudinal studies, such as the ISPOCD1 study (Moller et al., 1998), provide insights into the extended impact of surgery on cognitive functions, revealing possible long-term cognitive deficits.<br /><br />6. **Recommendations and Guidelines**:<br />   - Authoritative guidelines and recommendations are made for identifying and managing cognitive dysfunctions related to surgery and anesthesia (Evered et al., 2018).<br /><br />7. **Additional Risk Factors**:<br />   - Factors such as genetic predispositions (e.g., Apolipoprotein E e4 allele; Leung et al., 2007) and intraoperative burst suppression (Soehle et al., 2015) are discussed, highlighting their roles in the development of postoperative delirium.<br /><br />Overall, these sources collectively underscore the importance of preoperative assessment, customized anesthetic management, and diligent postoperative monitoring to mitigate cognitive impairments in elderly surgical patients.

Keywords

postoperative cognitive impairment

elderly patients

POCD

postoperative delirium

anesthesia methods

Bispectral Index monitoring

cognitive outcomes

delirium-preventive strategies

long-term cognitive deficits

genetic predispositions