Postoperative delirium: A tragedy for elderly cancer patients

Table 3 European Society of Anesthesiology and Intensive Care recommendations regarding the risk of postoperative delirium in elderly patients[29]

Recommendation	Quality of evidence	Strength of recommend
We recommend evaluating the following preoperative risk factors for POD: Older age, American Society of Anesthesiology Physical status score > 2, Charlson comorbidity index > 2, and Mini-Mental State Examination score lower than 25 points	Moderate	Strong
We do not suggest any specific type of surgery or type of anesthesia to reduce the incidence of POD	Low	Weak
When dexmedetomidine is used intra-operatively or postoperatively with the aim to prevent POD, we recommend balancing the expected benefits against the most important side effects (bradycardia and hypotension)	Moderate	Strong
We recommend that preoperative anesthesia consultation in older adults includes the screening for risk factors for POD and addresses patients’ needs to optimize their preoperative status	Low	Strong
We recommend that the results of the screening for POD risk factors are shared among the care team and the preventive strategies discussed and registered in the medical records	Low	Strong
We suggest Index-based EEG monitoring depth of anesthesia guidance to decrease the risk of POD	Low	Weak
We suggest multiparameter, intraoperative EEG monitoring (burst suppression, density spectral array) during anesthesia to decrease the risk of POD	Low	Weak

EEG: electroencephalogram; POD: Postoperative delirium.