Article description

To examine the effect of bispectral index (BIS)-guided anesthesia on the incidence of postoperative delirium (POD) in elderly patients undergoing surgery.

Summary:

• Meta-analysis aim wasto examine the effect of bispectral index (BIS)-guided anesthesia on the incidence of postoperative delirium (POD) in elderly patients undergoing surgery;
• Systematic review and meta-analysis of randomised controlled trials;
• The study included 10 RCTs with a study population size of 3891 patients, 5 low, 3 uncertain and 2 high risk of bias;
• Primary outcomes showed no significant difference in the incidence of POD in the BIS group compared to the control group (OR 0.71, 95% CI 0.47-1.08, p = 0.11;
• Secondary outcomes revealed a significantly lower incidence of postoperative cognitive dysfunction (POCD) (OR 0.64, 95% CI 0.46-0.88, p = 0.006), extubation time (mean difference [MD] -3.38 minutes, 95% CI -4.38 to -2.39, p < 0.00001), time to eye opening (MD -2.17 minutes, 95% CI -4.21 to -0.14, p = 0.04), and time to discharge from the PACU (MD -10.77 minutes, 95% CI -11.31 to – 10.23, p < 0.00001);

Conclusions:

• BIS guided anesthesia is associated with reduced incidence of postoperative cognitive dysfunction;
• Further studies with a standardized regimen of anesthesia (volatile v total intravenous anesthesia) are needed to improve the certainty of evidence.