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Comment & Response
June 25, 2019

Electroencephalography-Guided Anesthetic Administration and Postoperative Delirium—Reply

Author Affiliations
  • 1Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri
JAMA. 2019;321(24):2471-2472. doi:10.1001/jama.2019.5161

In Reply The generation of scientific knowledge is an iterative process. It is common for rigorous trials to modify or contradict previous evidence, especially when initial studies yield strongly positive results.1 The findings of the ENGAGES trial2 differ from the conclusion of a meta-analysis of trials that examined the effectiveness of intraoperative EEG guidance of anesthesia at preventing postoperative delirium.3 As such, the meta-analysis should be updated and the guidelines of the European Society of Anesthesiology and American Geriatric Society should be revised if necessary.