• Zhen Zhe Wong, Xin Hui Chiong, Sook Hui Chaw, Noorjahan Haneem Binti Md Hashim, Mohd Fitry Bin Zainal Abidin, Siti Nadzrah Binti Yunus, Thiruselvi Subramaniam, and Ka Ting Ng.
• School of Medicine, International Medical University, Kuala Lumpur, Malaysia.
• J. Cardiothorac. Vasc. Anesth. 2022 Jul 1; 36 (7): 2002-2011.

ObjectiveThe evidence on the use of cerebral oximetry during surgery to minimize postoperative neurologic complications remains uncertain in the literature. The present authors aimed to assess the value of cerebral oximetry in the prevention of postoperative cognitive dysfunction, postoperative delirium, and postoperative stroke in adults undergoing surgery.DesignA systematic review and meta-analysis.SettingThe surgery room.ParticipantsAdult patients (ages ≥18 years) undergoing surgery.InterventionsCerebral oximetry monitoring.Measurements And Main ResultsDatabases of Ovid MEDLINE, Ovid EMBASE, and CENTRAL were systematically searched from their inception until December 2020 for randomized controlled trials comparing cerebral oximetry monitoring with either blinded or no cerebral oximetry monitoring in adults undergoing surgery. Observational studies, case reports, and case series were excluded. Seventeen studies (n = 2,120 patients) were included for quantitative meta-analysis. Patients who were randomized to cerebral oximetry monitoring had a lower incidence of postoperative cognitive dysfunction (studies = seven, n = 969, odds ratio [OR] 0.23, 95% confidence interval [CI] 0.11-0.48, p = 0.0001; evidence = very low). However, no significant differences were observed in the incidence of postoperative delirium (studies = five, n = 716, OR 0.81, 95% CI 0.53-1.25, p = 0.35; evidence = high), and postoperative stroke (studies = seven, n = 1,087, OR 0.72, 95% CI 0.30-1.69, p = 0.45; evidence = moderate).ConclusionAdult patients with cerebral oximetry monitoring were associated with a significant reduction of postoperative cognitive dysfunction. However, given the low certainty of evidence and substantial heterogeneity, more randomized controlled trials using standardized assessment tools for postoperative cognitive dysfunction and interventions of correcting cerebral desaturation are warranted to improve the certainty of evidence and homogeneity.Copyright © 2021 Elsevier Inc. All rights reserved.

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