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01 October 2020 : Database Analysis  

Comparison of Bispectral Index-Guided Individualized Anesthesia with Standard General Anesthesia on Inadequate Emergence and Postoperative Delirium in Elderly Patients Undergoing Esophagectomy: A Retrospective Study at a Single Center

Yichen Yang1ACDEF, Chengjun Song2BCDEF, Chengwei Song2BCDEF, Chengwen Li3ACDEFG*

DOI: 10.12659/MSM.925314

Med Sci Monit 2020; 26:e925314


BACKGROUND: Elderly patients are susceptible to general anesthetics, with a higher bispectral index (BIS) at loss of consciousness (LOC) achieved by propofol infusion compared with young patients. Overexposure to general anesthetics can have adverse effects such as inadequate emergence and postoperative delirium (PD). This study aimed to compare the effects of BIS-guided individualized anesthesia with standard general anesthesia on emergence and delirium after esophagectomy.

MATERIAL AND METHODS: Data on 161 elderly patients undergoing esophagectomy for cancer were retrospectively obtained from electronic medical records. We performed propensity score matching analysis between patients receiving individualized anesthesia (BIS value maintained at about 10 less than the value at LOC) and those receiving standard anesthesia (BIS value maintained at 40–60). In addition, we conducted univariate and multivariate logistic ­analyses in the entire cohort.

RESULTS: Patients receiving individualized anesthesia had higher BIS values and a lower propofol requirement during surgery than those receiving standard general anesthesia (P<0.05). The overall incidences of inadequate emergence and PD were 37.9% and 18.0% (n=161), respectively. Logistic regression analysis revealed that the independent risk factors for PD were organic brain disease (odds ratio [OR] 6.308; 95% confidence interval [CI] 2.458–16.187) and inadequate emergence (OR 4.063; 95% CI 1.645–10.033).

CONCLUSIONS: BIS-guided individualized anesthesia (lighter) does not reduce inadequate emergence or PD compared with standard general anesthesia in elderly patients undergoing esophagectomy. Independent risk factors for PD include organic brain disease and inadequate emergence.

Keywords: Anesthesia, General, Delayed Emergence from Anesthesia, Delirium, Esophagectomy, Postoperative Complications



01 December 2021 : Editorial  

Editorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19

Dinah V. Parums
Scientific Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.935624

Med Sci Monit 2021; 27:e935624


03 December 2021 : Laboratory Research  

Influenza and Influenza-Like Respiratory Virus Infections in Children During the 2019/20 Influenza Season a...

Med Sci Monit In Press; DOI: 10.12659/MSM.934862  

08 November 2021 : Database Analysis  

Virtual Screening and Molecular Docking to Study the Mechanism of Chinese Medicines in the Treatment of Cor...

Med Sci Monit In Press; DOI: 10.12659/MSM.934102  

01 December 2021 : Editorial  

Editorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19

Med Sci Monit 2021; 27:e935624

In Press

06 Dec 2021 : Animal Research  

Astragalus Flavone Induces Proliferation and Differentiation of Neural Stem Cells in a Cerebral Infarction ...

Med Sci Monit In Press; DOI: 10.12659/MSM.933830  

06 Dec 2021 : Clinical Research  

Alteration of Serum Metabolites in Women of Reproductive Age with Chronic Constipation

Med Sci Monit In Press; DOI: 10.12659/MSM.934117  

06 Dec 2021 : Clinical Research  

Body Composition Changes and Related Factors in Patients with Ulcerative Colitis: A Retrospective Single-Ce...

Med Sci Monit In Press; DOI: 10.12659/MSM.933942  

03 Dec 2021 : Clinical Research  

A Retrospective Single-Center Study of 23 Patients to Compare Gait Before and After Total Hip Arthroplasty ...

Med Sci Monit In Press; DOI: 10.12659/MSM.934558  

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750