Relationship between intraoperative EEG spindle loss and emergence delirium in elderly patients undergoing joint replacement surgery

Abstract

Objective To investigate the relationship between intraoperative electroencephalographic (EEG) spindle loss and emergence delirium (ED) in elderly patients undergoing joint replacement surgery, and to further analyze the independent risk factors for ED. Methods A total of 69 elderly patients who underwent joint replacement surgery under general anesthesia in The Affiliated Hospital of Qingdao University from November 2020 to February 2021 were selected. Preoperative and intraoperative indicators, as well as length of stay in postanesthesia care unit and postoperative delirium incidence, were recorded. According to the presence or absence of EEG spindle waves, the patients were divided into spindle group and spindle loss group, and the relationship between intraoperative EEG spindle loss and ED was analyzed. The patients were then divided into ED group and non-ED group according to the presence or absence of ED after surgery. A univariate analysis was performed on various indicators of patients in the two groups. Factors with P<0.05 in univariate analysis and risk factors reported in previous studies were included in a multivariate logistic regression analysis model to identify independent risk factors for ED. Results The results of univariate analysis showed that the proportion of ED in the spindle loss group was significantly higher than that in the spindle group (χ2=11.189,P<0.05). There were significant differences in age, sex, stroke history, and the proportion of EEG spindle loss between the ED group and the non-ED group (t=-3.804,χ2=4.071-11.189,P<0.05). The multivariate logistic regression analysis showed that age (OR=1.197,95%CI=1.066-1.344) and intraoperative EEG spindle loss (OR=6.062,95%CI=1.384-26.543) were indepen-dent risk factors for ED. Conclusion In elderly patients undergoing joint replacement surgery under general anesthesia, intrao-perative EEG spindle loss is associated with the occurrence of ED. Intraoperative EEG spindle loss and age are independent risk factors for ED and may be important reference indicators for predicting the occurrence of ED.

Keywords

• arthroplasty, replacement|emergence delirium|spindle|electroencephalography|anesthesia, general|risk factors|aged