Speakers
Prof. Kate LESLIE
Professor
Royal Melbourne Hospital
Australia
Professor Kate Leslie is a specialist anaesthetist and head of research in the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, and honorary professorial fellow at the University of Melbourne and Monash University. Kate is a former ANZCA president and is currently the president of the Australian Medical Council, the accreditation authority for medicine in Australia. Kate is a foundation member of the ANZCA Clinical Trials Network and was the chair between 2014-7. She was a leader of the B-Aware, ENIGMA, POISE, RELIEF, Balanced and PADDI studies, and is currently a chief investigator of the ROCKet, POISE-3, Chewy and SNaPP studies.
Postoperative delirium (POD) is part of a spectrum of disorders that have recently been described as “perioperative neurocognitive disorders (PND)”. POD is an acute onset fluctuating change in mental status characterized by a reduced awareness of the environment and disturbance of attention. It is common in the first seven days postoperatively, particularly in older adults. The pathophysiologic basis for delirium is uncertain. Anaesthesia and surgery are associated with immunosuppression, inflammation and hypotension. These may be greater with deep anaesthesia. More than nine studies investigated the association between deep anaesthesia and delirium. Most showed an advantage of light anaesthesia with only one (ENGAGES) have a different conclusion. Our recent Balanced Anaesthesia Study sub-study on delirium reported a lower rate of delirium in the light GA group compared with the deep GA group. Questions remain about the relative importance of anaesthetic dose and EEG effect on the rate of delirium.
