Postoperative neurocognitive disorders (PND) are serious and common complications after surgery, especially in elderly patients. These disorders can affect cognitive functions for years, deteriorating quality of life and increasing hospital stays and medical costs. Diagnosing PND is challenging due to their varied manifestations, such as memory and attention problems, and the lack of standardized criteria and biomarkers.
One well-studied form of PND is postoperative delirium (POD). According to the ICD-10, POD is an organic cerebral syndrome characterized by disturbances in consciousness, attention, perception, and other cognitive functions. Researchers suggest that POD development involves a combination of predisposing and precipitating factors.
Electroencephalography (EEG) has been used in anesthesiology to assess anesthesia depth and intraoperative awareness. Modern EEG analysis methods, like spectral analysis, offer new ways to evaluate patients' neurophysiological states. Studies show that EEG monitoring can predict complications such as intraoperative stroke and delirium, particularly in cardiothoracic and neurosurgical operations.
The relationship between EEG patterns and POD is not well understood. Specific EEG patterns may indicate the risk of POD, aiding in the identification of risk factors and prevention methods. This could help anesthesiologists and surgeons optimize their approaches, reducing the risk of cognitive complications.
Age ≥ 18 years
Scheduled non-cardiac surgery of intermediate or high risk
General anesthesia using inhalational anesthetics
Informed consent from the patient to participate in the study
Preoperative MMSE score less than 20 points
History of any mental illness
Use of psychotropic drugs within 1 month prior to inclusion in the study
Presence of neuromuscular diseases
Patients scheduled for non-cardiac surgery of intermediate to high risk
Cohort
Prospective
Intraoperative electroencephalography
DeviceEEG recording will be performed using the standard 16-electrode configuration according to the international "10-20" system. During the recording, electrode impedances will be maintained at a level not exceeding 5 kilo-ohms.
Prognostic value of mean intraoperative alpha rhythm power for the development of postoperative delirium
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Prognostic value of mean intraoperative alpha rhythm power for the development of early postoperative neurocognitive disorders
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Prognostic value of mean intraoperative alpha rhythm power for the development of intraoperative silent brain infarction
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Prognostic value of maximum intraoperative alpha rhythm power for the development of postoperative delirium
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Prognostic value of maximum intraoperative alpha rhythm power for the development of early postoperative neurocognitive disorders
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Prognostic value of maximum intraoperative alpha rhythm power for the development of silent brain infarction
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
The prognostic capability of the "burst suppression" pattern for predicting the development of silent brain infarction
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Serum level of S100 beta protein
Serum level of Interleukin-6
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