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Intermediate Cervical Plexus
OA-Reg. Anes. Block of the Month: January 2025
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Question of the Day
Which of the following interventions would be MOST likely to DECREASE the risk of postoperative cognitive decline?
Explanation
Postoperative cognitive dysfunction involves subjective cognitive decline in different cognitive domains that usually resolves within 3 months following surgery in susceptible individuals. Several studies have evaluated the use of a Bispectral index (BIS) and careful titration of anesthesia to a goal BIS level in order to decrease the risk of postoperative cognitive dysfunction. In the Cognitive Dysfunction After Anesthesia trial, investigators randomized patients to maintenance of anesthesia with a BIS level of 40-60 (average BIS 53) compared to normal anesthesia administration (average BIS 36.) The results of this trial included reduced rates of postoperative cognitive dysfunction in the intervention group.
References:
Chan MT, Cheng BC, Lee TM, Gin T; CODA Trial Group. BIS-guided anesthesia decreases postoperative delirium and cognitive decline. J Neurosurg Anesthesiol. 2013;25(1):33-42. doi:10.1097/ANA.0b013e3182712fba Green D, Ballard C, Kunst G. Depth of anaesthesia optimisation and postoperative cognitive dysfunction. Br J Anaesth. 2015;114(2):343-344. doi:10.1093/bja/aeu471 Postoperative Delirium in Aging Patients
OA Series: January 2025
