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Article Dans Une Revue Frontiers in Aging Neuroscience Année : 2020

Propofol Requirement and EEG Alpha Band Power During General Anesthesia Provide Complementary Views on Preoperative Cognitive Decline

Résumé

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 SEF 95 : 8–13 Hz) and the frontal alpha band power (AP at SEF 95 : 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.
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hal-03519484 , version 1 (10-01-2022)

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Cyril Touchard, Jérôme Cartailler, Charlotte Levé, José Serrano, David Sabbagh, et al.. Propofol Requirement and EEG Alpha Band Power During General Anesthesia Provide Complementary Views on Preoperative Cognitive Decline. Frontiers in Aging Neuroscience, 2020, ⟨10.3389/fnagi.2020.593320⟩. ⟨hal-03519484⟩
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