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Journal Article

Propofol requirement and EEG alpha band power during general anesthesia provide complementary views on preoperative cognitive decline

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Engemann,  Denis A.
Centre Inria Saclay de l'université Paris Sud, France;
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Citation

Touchard, C., Cartailler, J., Levé, C., Serrano, J., Sabbagh, D., Manquat, E., et al. (2020). Propofol requirement and EEG alpha band power during general anesthesia provide complementary views on preoperative cognitive decline. Frontiers in Aging Neuroscience, 12: 593320. doi:10.3389/fnagi.2020.593320.


Cite as: https://hdl.handle.net/21.11116/0000-0007-E497-D
Abstract
Background: Although cognitive decline (CD) is associated with increased post-operative morbidity and mortality, routinely screening patients remains difficult. The main objective of this prospective study is to use the EEG response to a Propofol-based general anesthesia (GA) to reveal CD.

Methods: 42 patients with collected EEG and Propofol target concentration infusion (TCI) during GA had a preoperative cognitive assessment using MoCA. We evaluated the performance of three variables to detect CD (MoCA < 25 points): age, Propofol requirement to induce unconsciousness (TCI at SEF95: 8–13 Hz) and the frontal alpha band power (AP at SEF95: 8–13 Hz).

Results: The 17 patients (40%) with CD were significantly older (p < 0.001), had lower TCI (p < 0.001), and AP (p < 0.001). We found using logistic models that TCI and AP were the best set of variables associated with CD (AUC: 0.89) and performed better than age (p < 0.05). Propofol TCI had a greater impact on CD probability compared to AP, although both were complementary in detecting CD.

Conclusion: TCI and AP contribute additively to reveal patient with preoperative cognitive decline. Further research on post-operative cognitive trajectory are necessary to confirm the interest of intra operative variables in addition or as a substitute to cognitive evaluation.