• Cyril Touchard, Jérôme Cartailler, Charlotte Levé, Pierre Parutto, Cédric Buxin, Lucas Garnot, Joaquim Matéo, Nathalie Kubis, Alexandre Mebazaa, Etienne Gayat, and Fabrice Vallée.
• Department of Anesthesiology and Intensive Care, Lariboisière - Saint Louis Hospitals, Paris, France. Electronic address: cyriltouchard@hotmail.fr.
• Clin Neurophysiol. 2019 Aug 1; 130 (8): 1311-1319.

ObjectiveUnder General Anesthesia (GA), age and Burst Suppression (BS) are associated with cognitive postoperative complications, yet how these parameters are related to per-operative EEG and hypnotic doses is unclear. In this prospective study, we address this question comparing age and BS occurrences with a new score (BPTIVA) based on Propofol doses, EEG and alpha-band power spectral densities, evaluated for SEF95 = 8-13 Hz.Methods59 patients (55 [34-67] yr, 67% female) undergoing neuroradiology or orthopedic surgery were included. Total IntraVenous Anesthesia was used for Propofol and analgesics infusion. Cerebral activity was monitored from a frontal electrodes montage EEG.ResultsBPTIVA was inversely correlated with age (Pearson r = -0.78, p < 0.001), and was significantly lower (p < 0.001) when BS occurred during the GA first minutes (induction). Additionally, the age-free BPTIVA score was better associated with BS at induction than age (AUC = 0.94 versus 0.82, p < 0.05).ConclusionWe designed BPTIVA score based on hypnotics and EEG. It was correlated with age yet was better associated to BS occurring during GA induction, the latter being a cerebral fragility sign.SignificanceThis advocate for an approach based on evaluating the cerebral physiological age («brain age») to predict postoperative cognitive evolution.Copyright © 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

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