• Maria J Bruzzone, Benjamin Chapin, Jessie Walker, Marcos Santana, Yue Wang, Shawna Amini, Faith Kimmet, Estefania Perera, Clio Rubinos, Franchesca Arias, and Catherine Price.
• From the Department of Neurology, University of Florida, Gainesville, Florida.
• Anesth. Analg. 2024 Aug 1.

AbstractPostoperative delirium (POD) is frequent in older adults and is associated with adverse cognitive and functional outcomes. In the last several decades, there has been an increased interest in exploring tools that easily allow the early recognition of patients at risk of developing POD. The electroencephalogram (EEG) is a widely available tool used to understand delirium pathophysiology, and its use in the perioperative setting has grown exponentially, particularly to predict and detect POD. We performed a systematic review to investigate the use of EEG in the pre-, intra-, and postoperative settings. We identified 371 studies, and 56 met the inclusion criteria. A range of techniques was used to obtain EEG data, from limited 1-4 channel setups to complex 256-channel systems. Power spectra were often measured preoperatively, yet the outcomes were inconsistent. During surgery, the emphasis was primarily on burst suppression (BS) metrics and power spectra, with a link between the frequency and timing of BS, and POD. The EEG patterns observed in POD aligned with those noted in delirium in different contexts, suggesting a reduction in EEG activity. Further research is required to investigate preoperative EEG indicators that may predict susceptibility to delirium.Copyright © 2024 International Anesthesia Research Society.

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