The Effect Of EEG Wavelet Detection Guides General Anesthesia On Post-operative Delirium In Elderly Patients

Background and ObjectivePost-operative Delirium(POD)is one of the most common complications in elderly critically ill patients after surgery.11% to 51% of patients develop delirium after surgery,and the incidence increases with age.Increased,POD seriously affects the prognosis of patients,but 40% of POD is preventable.The interaction of general anesthetics with brain function may lead to POD.The depth of anesthesia is closely related to the patient's POD.EEG monitoring under general anesthesia can detect Burst Suppression(BS),which may be related to the excessive use of general anesthetics to cause anesthesia.The relationship between BS and POD has been controversial in past research and needs further exploration.EEG wavelet monitoring can extract the indicators reflecting the depth of sedation and depth of analgesia in EEG signals,thereby monitoring the depth of sedation and the depth of analgesia to guide the use of intraoperative anesthetics.Sensitivity and effectiveness of sedation depth have been confirmed by several studies,but the sensitivity to the depth of analgesia needs further study.The purpose of this study was to investigate whether the use of EEG wavelet monitoring to guide the use of drugs can reduce the incidence of POD;to study the effects of propofol and sevoflurane on the maintenance of POD for general anesthetics;and whether BS and POD occur Related.Materials and MethodsScreening patients who underwent radical resection of colon cancer at the First Affiliated Hospital of Zhengzhou University from September 2017 to January 2019,based on the use of EEG monitoring and intraoperative sedation to maintain cross-intervention with propofol or sevoflurane.Patients were divided into 4 groups according to the random number table method.All patients underwent routine monitoring after entering the room.Patients in the EEG wavelet monitoring group were monitored for EEG,administered in groups,and the operation time and intraoperative anesthetic dose and adverse events were recorded.POD was assessed at the time of anesthesia recovery room and 1 to 3 days after surgery.ResultsA total of 125 patients were enrolled in the trial,30 in each group,and 5 were excluded.There was no significant difference in the general data between the 4 groups(P>0.05).Compared with the non-EEG wavelet monitoring group,the patients in the EEG wavelet monitoring group had less sedatives and analgesic medications,and the incidence of POD was lower(P<0.05);There was no significant difference in the incidence of POD between patients with sevoflurane and those with propofol(P>0.05).There was no significant correlation between the incidence of BS and POD(P>0.05).ConclusionThe use of EEG wavelet monitoring to guide the intraoperative medication can reduce the incidence of POD,reduce the amount of intraoperative sedation,analgesics;propofol and sevoflurane have no significant difference in the incidence of POD;this experiment can not explain BS and The occurrence of POD is related.