Features  |   February 2019
Update on the Science Underlying the Perioperative Brain Health Initiative
Author Affiliations
  • Stacie Deiner, M.S., M.D.
    Ad Hoc Committee on Perioperative Brain Health Initiative
  • Roderic G. Eckenhoff, M.D.
    Ad Hoc Committee on Perioperative Brain Health Initiative
Article Information
Central and Peripheral Nervous Systems / Geriatric Anesthesia / Features
Features   |   February 2019
Update on the Science Underlying the Perioperative Brain Health Initiative
ASA Monitor 2 2019, Vol.83, 14-15.
ASA Monitor 2 2019, Vol.83, 14-15.
The trajectory of interest and investigation into perioperative brain health over the last year has continued to increase, with many publications and much activity in the basic and clinical research arenas. Independent of our understanding of the risk factors and mechanisms, the question that many anesthesia providers are asking is, how should we change our practice for older adults undergoing surgery? While there are guidelines and best practice documents published by other societies such as the American College of Surgeons and the American Geriatrics Society, a recent study of the ASA membership suggests that anesthesiologists are interested in guidelines for the care of older adults specifically endorsed by ASA. Some of these “best practices” questions were addressed by anesthesiologist researchers in the 5th International Workshop of Perioperative Neurotoxicity in the Elderly in 2016. This workshop included approximately 30 experts in the field and, using a consensus approach, settled on four major questions and the respective recommendations. The manuscript, led by Miles Berger, M.D., Ph.D., at Duke, was just published1  and will serve as an important placeholder in anticipation of the nascent ASA-sponsored consensus process. The process will include development of a list of questions, which will be addressed with weighted recommendations, by an invited group of experts using an iterative Delphi process. We anticipate consensus guidelines to address important questions in the care of older adults to be submitted for publication in late 2019.
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