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Anaesthetic Depth and Complications after Surgery: an International Randomized Controlled Trial

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Previous observational studies have demonstrated an association between increased anesthetic depth and decreased post-op survival. However, there have been minimal randomized controlled trials to provide direct evidence of this. The aim of this study was to compare all cause 1-year mortality in older patients (over age 60) who underwent major surgery. A total of 6,668 patients were enrolled in the study from 73 medical centers in seven countries. Patients were categorized in light or deep general anesthesia using the bispectral index (BIS) target of BIS 50 (light anesthesia) or BIS 35 (deep anesthesia). The study found no evidence of a difference in mortality or the incidence of complications between the two groups at 1 year. This finding is suggestive that there may be a broad range of anesthetic depth that can safely be administered to older patients.

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Short TG, Campbell D, Frampton C, et al. Anaesthetic depth and complications after major surgery: an international, randomised controlled trial. Lancet. 2019 Nov 23;394(10212):1907-1914.

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