Anaesthetic depth and complications after major surgery: An international, randomised controlled trial
The Lancet Oct 30, 2019
Short TG, Campbell D, Frampton C, et al. - Researchers undertook an international trial in older patients having major surgery, to compare all-cause 1-year mortality between those randomly assigned to light anaesthesia and those who received deep general anaesthesia, given observational studies have reported a link between increasing anaesthetic depth and decreased postoperative survival. Participants were selected from 73 centres in seven countries. The participants with age 60 years and older, carrying significant comorbidity, having surgery with an expected duration of more than 2 h, and an expected hospital stay of at least 2 days, were recruited. Random allocation of the patients with increased risk of complications following major surgery to receive light general anaesthesia (bispectral index [BIS] target 50) or deep general anaesthesia (BIS target 35) was done. Findings revealed that light general anaesthesia vs deep general anaesthesia was not related to lower 1-year mortality among participants. A wide range of anaesthetic depth was described over which anaesthesia may be safely administered when titrating volatile anaesthetic levels employing a processed electroencephalographic monitor.
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