Bilateral Bispectral Index and Asymmetries in High Risk Patients for Postoperative Delirium: An Observational, Prospective, Exploratory Study

What this Trial Is About

This research aims to describe the value of interhemispheric asymmetry (ASYM) measured by bilateral Bispectral Index (BIS) monitoring during different intraoperative and perioperative phases. It focuses on patients undergoing head and neck or plastic surgery who are at a higher risk of developing postoperative delirium (POD) within 30 days and postoperative cognitive dysfunction (POCD) within 90 days after surgery. Each participant will have two BIS sensors placed on their forehead to monitor brain activity in each hemisphere non-invasively during surgery. Data will be collected at specific timepoints including before anesthesia, after muscle relaxation, intubation, surgical incision, end of anesthesia, and after extubation. Daily assessments for POD will occur for five days post-surgery, with follow-up phone calls at 30 and 90 days to monitor POD and POCD using CAM, 6-CIT, and EQ50 tests. During the study, researchers will monitor brain asymmetries and other EEG-derived parameters to investigate their correlation with POD and POCD. Participants will undergo regular clinical evaluations, cognitive testing, and monitoring in the hospital and via telephone. The primary outcome is the correlation between intraoperative asymmetry values and postoperative delirium or cognitive dysfunction occurrence. The study duration includes perioperative monitoring and follow-up extending up to 90 days after surgery.

Bilateral Bispectral Index, Asymmetries and Post-operative Delirium