Cardiothoracic & vascular anesthesia
Electroencephalography-Guided Anesthesia and Delirium in Older Adults After Cardiac Surgery: The ENGAGES-Canada Randomized Clinical Trial
Primary result · DeliriumResult — go to the resultDifference 0.05% 95% CI −4.57% to 4.67%Authors' conclusion
Among older adults undergoing cardiac surgery, EEG-guided anesthetic administration to minimize EEG suppression, compared with usual care, did not decrease the incidence of postoperative delirium.
Study context
- Population
- Adults ≥60 years undergoing cardiac surgery1,131 (99.2%) assessed for primary outcome
- Participants
- 1,140 adults
- Comparison
- EEG-guided anesthesia vs usual care
- EEG-guidedn = 567
- Usual caren = 573reference
- Primary endpoint
- Delirium
- Follow-up
- Postoperative days 1 through 5
Methodological detailsparallel-group, patient- and outcome assessor-blinded, 4 Canadian hospitals, stratified by hospital, Recruitment December 2016 to February 2022, follow-up until February 2023
- Parallel-group
- Patient- and outcome assessor-blinded
- 4 Canadian hospitals
- Stratified by hospital
- Recruitment December 2016 to February 2022, follow-up until February 2023
Primary result
As reported in the abstract
postoperative days 1 to 5
Difference
0.05%
95% CI −4.57% to 4.67%
Events by treatment group
EEG-guided vs Usual care
difference 0.05% (95% CI −4.57% to 4.67%)
Secondary outcomes
| Outcome | EEG-guided | Usual care | Estimate |
|---|---|---|---|
| Median volatile anesthetic minimum alveolar concentration (intraoperative)Lower with EEG-guided | 0.66 | 0.80 | difference 0.14 (95% CI 0.15–0.13) |
| Median total time with EEG suppression (intraoperative)Decrease with EEG-guided · min | 4.0 | 11.7 | difference 7.7 minute (95% CI 10.6–4.7) |
Median ICU and hospital length of stay
- No significant difference between groups in median ICU length of stay
- difference, 0 days [95% CI, −0.31 to 0.31]
- No significant difference between groups in median hospital stay
- difference, 0 days [95% CI, −0.94 to 0.94]
Safety
Medical complications
Intraoperative awareness
- No patients reported intraoperative awareness
Original publication
Electroencephalography-Guided Anesthesia and Delirium in Older Adults After Cardiac Surgery: The ENGAGES-Canada Randomized Clinical Trial. JAMA. Published 9 July 2024. doi:10.
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