Neuroanesthesia

Blunted frontal alpha shift at induction tracked with postoperative delirium in older adults

In an exploratory study of 83 older patients with usable EEG under sevoflurane, those who developed delirium (19 of 100 enrolled) lacked the alpha power increase seen before loss of responsiveness (frontal 4.24 vs -0.88 dB) and had less efficient functional brain networks during maintenance.

Why it matters. Raises the possibility of an intraoperative EEG marker of delirium susceptibility.

Limitation. Small single-center exploratory study; 17 patients were excluded for EEG artifacts.

CT angiography for brain death was far less sensitive within 12 hours of brainstem areflexia

In 118 ICU patients undergoing death determination by neurological criteria, cerebral CTA sensitivity was 87.3% overall: 67.4% when performed within 12 h of the first signs of brainstem areflexia vs 98.7% after 12 h. The authors recommend waiting at least 12 h and repeating inconclusive scans.

Why it matters. Offers a practical timing rule that could reduce false-negative ancillary testing.

Limitation. Retrospective cohort; the authors call for confirmation of the 12-hour threshold.

Remimazolam vs Propofol for Motor and Somatosensory Evoked Potentials in Spinal Tumor Surgery

Phase 4 trial planning 190 participants, sponsored by Beijing Tsinghua Chang Gung Hospital. Status: not yet recruiting. Conditions: Spinal Cord Neoplasms, Spinal Neoplasms.