{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T09:02:14Z","timestamp":1784710934997,"version":"3.55.0"},"reference-count":47,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001136","name":"Australian and New Zealand College of Anaesthetists","doi-asserted-by":"publisher","award":["17\/009"],"award-info":[{"award-number":["17\/009"]}],"id":[{"id":"10.13039\/501100001136","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001537","name":"University of Auckland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001537","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000913","name":"James S McDonnell Foundation","doi-asserted-by":"publisher","award":["220023046"],"award-info":[{"award-number":["220023046"]}],"id":[{"id":"10.13039\/100000913","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjanaesthesia.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["British Journal of Anaesthesia"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1016\/j.bja.2025.07.051","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T12:00:16Z","timestamp":1758628816000},"page":"1263-1274","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"title":["EEG alpha power and delirium in the postanaesthesia care unit in older adults: the AlphaMax trial part 2 - effect of propofol infusion during emergence from desflurane anaesthesia\u2606"],"prefix":"10.1016","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6641-1908","authenticated-orcid":false,"given":"Antara","family":"Banerji","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7298-0250","authenticated-orcid":false,"given":"Amy L.","family":"Gaskell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logan J.","family":"Voss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9216-471X","authenticated-orcid":false,"given":"Rebecca M.","family":"Pullon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9812-9790","authenticated-orcid":false,"given":"Jonathan","family":"Termaat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul S.","family":"Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1966-5825","authenticated-orcid":false,"given":"Jamie W.","family":"Sleigh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.bja.2025.07.051_bib1","doi-asserted-by":"crossref","first-page":"146","DOI":"10.3389\/fnsys.2014.00146","article-title":"Emergence from general anesthesia and the sleep-manifold","volume":"8","author":"Hight","year":"2014","journal-title":"Front Syst Neurosci"},{"key":"10.1016\/j.bja.2025.07.051_bib2","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/ANA.0000000000000212","article-title":"The neurobiology of anesthetic emergence","volume":"28","author":"Tarnal","year":"2016","journal-title":"J Neurosurg Anesthesiol"},{"key":"10.1016\/j.bja.2025.07.051_bib3","doi-asserted-by":"crossref","DOI":"10.1016\/j.jclinane.2022.110949","article-title":"The absence of dominant alpha-oscillatory EEG activity during emergence from delta-dominant anesthesia predicts neurocognitive impairment \u2013 results from a prospective observational trial","volume":"82","author":"Lutz","year":"2022","journal-title":"J Clin Anesth"},{"key":"10.1016\/j.bja.2025.07.051_bib4","doi-asserted-by":"crossref","DOI":"10.3389\/fnagi.2022.949148","article-title":"Mitigation of perioperative neurocognitive disorders: a holistic approach","volume":"14","author":"Safavynia","year":"2022","journal-title":"Front Aging Neurosci"},{"key":"10.1016\/j.bja.2025.07.051_bib5","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1213\/ANE.0000000000004781","article-title":"Low frontal alpha power is associated with the propensity for burst suppression: an electroencephalogram phenotype for a \u201cvulnerable brain\u201d","volume":"131","author":"Shao","year":"2020","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bja.2025.07.051_bib6","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1038\/s42003-019-0575-3","article-title":"Alpha rhythm collapse predicts iso-electric suppressions during anesthesia","volume":"2","author":"Cartailler","year":"2019","journal-title":"Commun Biol"},{"key":"10.1016\/j.bja.2025.07.051_bib7","doi-asserted-by":"crossref","first-page":"56","DOI":"10.3389\/fnsys.2019.00056","article-title":"Intraoperative low alpha power in the electroencephalogram is associated with postoperative subsyndromal delirium","volume":"13","author":"Gutierrez","year":"2019","journal-title":"Front Syst Neurosci"},{"key":"10.1016\/j.bja.2025.07.051_bib8","unstructured":"A. Gaskell. Modulation of frontal EEG alpha oscillations during maintenance of anaesthesia and Post Anaesthesia Care Unit delirium: results from the \u2018AlphaMax\u2019 study (Part I). AlphaMax randomised trial (Part 1). In press"},{"key":"10.1016\/j.bja.2025.07.051_bib9","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1097\/ACO.0000000000000076","article-title":"Emergence delirium in children: an update","volume":"27","author":"Dahmani","year":"2014","journal-title":"Curr Opin Anesthesiol"},{"key":"10.1016\/j.bja.2025.07.051_bib10","doi-asserted-by":"crossref","DOI":"10.3389\/fsurg.2022.1031010","article-title":"Efficacy of propofol for the prevention of emergence agitation after sevoflurane anaesthesia in children: a meta-analysis","volume":"9","author":"Xiao","year":"2022","journal-title":"Front Surg"},{"key":"10.1016\/j.bja.2025.07.051_bib11","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1111\/pan.12617","article-title":"Transition to propofol after sevoflurane anesthesia to prevent emergence agitation: a randomized controlled trial","volume":"25","author":"Costi","year":"2015","journal-title":"Paediatr Anaesth"},{"key":"10.1016\/j.bja.2025.07.051_bib12","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1111\/pan.12669","article-title":"Does a prophylactic dose of propofol reduce emergence agitation in children receiving anesthesia? A systematic review and meta-analysis","volume":"25","author":"van Hoff","year":"2015","journal-title":"Paediatr Anaesth"},{"key":"10.1016\/j.bja.2025.07.051_bib13","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.bja.2018.09.016","article-title":"Association of electroencephalogram trajectories during emergence from anaesthesia with delirium in the postanaesthesia care unit: an early sign of postoperative complications","volume":"122","author":"Hesse","year":"2019","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bja.2025.07.051_bib14","doi-asserted-by":"crossref","DOI":"10.3389\/fnagi.2022.930434","article-title":"Deconstructing delirium in the post anaesthesia care unit","volume":"14","author":"Banerji","year":"2022","journal-title":"Front Aging Neurosci"},{"key":"10.1016\/j.bja.2025.07.051_bib15","doi-asserted-by":"crossref","DOI":"10.3389\/fnhum.2021.706693","article-title":"Distinct and dissociable EEG networks are associated with recovery of cognitive function following anesthesia-induced unconsciousness","volume":"15","author":"Rokos","year":"2021","journal-title":"Front Hum Neurosci"},{"key":"10.1016\/j.bja.2025.07.051_bib16","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.59525","article-title":"Recovery of consciousness and cognition after general anesthesia in humans","volume":"10","author":"Mashour","year":"2021","journal-title":"eLife"},{"key":"10.1016\/j.bja.2025.07.051_bib17","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/S0006-3223(99)00187-0","article-title":"Working memory constrains abstraction in schizophrenia","volume":"47","author":"Glahn","year":"2000","journal-title":"Biol Psychiatry"},{"key":"10.1016\/j.bja.2025.07.051_bib18","doi-asserted-by":"crossref","first-page":"942","DOI":"10.3357\/AMHP.4343.2015","article-title":"Development and validation of the Cognition Test Battery for Spaceflight","volume":"86","author":"Basner","year":"2015","journal-title":"Aerosp Med Hum Perform"},{"key":"10.1016\/j.bja.2025.07.051_bib19","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1097\/ALN.0000000000003193","article-title":"An introduction to causal diagrams for anesthesiology research","volume":"132","author":"Gaskell","year":"2020","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bja.2025.07.051_bib20","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1186\/s13063-019-3178-x","article-title":"Modulation of frontal EEG alpha oscillations during maintenance and emergence phases of general anaesthesia to improve early neurocognitive recovery in older patients: protocol for a randomised controlled trial","volume":"20","author":"Gaskell","year":"2019","journal-title":"Trials"},{"key":"10.1016\/j.bja.2025.07.051_bib21","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"},{"key":"10.1016\/j.bja.2025.07.051_bib22","doi-asserted-by":"crossref","first-page":"554","DOI":"10.7326\/M14-0865","article-title":"3D-CAM: derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study","volume":"161","author":"Marcantonio","year":"2014","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.bja.2025.07.051_bib23","doi-asserted-by":"crossref","first-page":"917","DOI":"10.3233\/JAD-170555","article-title":"Assessing working memory in mild cognitive impairment with serial order recall","volume":"61","author":"Emrani","year":"2018","journal-title":"J Alzheimers Dis"},{"key":"10.1016\/j.bja.2025.07.051_bib24","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1002\/jhm.2418","article-title":"Preliminary development of an ultrabrief two-item bedside test for delirium","volume":"10","author":"Fick","year":"2015","journal-title":"J Hosp Med"},{"key":"10.1016\/j.bja.2025.07.051_bib25","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1001\/jama.286.21.2703","article-title":"Delirium in mechanically ventilated patients: validity and reliability of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)","volume":"286","author":"Ely","year":"2001","journal-title":"JAMA"},{"key":"10.1016\/j.bja.2025.07.051_bib26","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.jpainsymman.2004.07.009","article-title":"Fast, systematic, and continuous delirium assessment in hospitalized patients: the Nursing Delirium Screening Scale","volume":"29","author":"Gaudreau","year":"2005","journal-title":"J Pain Symptom Manage"},{"key":"10.1016\/j.bja.2025.07.051_bib27","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1164\/rccm.2107138","article-title":"The Richmond Agitation\u2013Sedation Scale: validity and reliability in adult intensive care unit patients","volume":"166","author":"Sessler","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.bja.2025.07.051_bib28","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1097\/ALN.0b013e318289b84b","article-title":"Development and psychometric evaluation of a postoperative Quality of Recovery score: the QoR-15","volume":"118","author":"Stark","year":"2013","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bja.2025.07.051_bib29","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1093\/bja\/42.6.535","article-title":"A simple study of awareness and dreaming during anaesthesia","volume":"42","author":"Brice","year":"1970","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bja.2025.07.051_bib30","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0106291","article-title":"Electroencephalographic variation during end maintenance and emergence from surgical anesthesia","volume":"9","author":"Chander","year":"2014","journal-title":"PLoS One"},{"key":"10.1016\/j.bja.2025.07.051_bib31","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1213\/ANE.0000000000005783","article-title":"The first derivative of the electroencephalogram facilitates tracking of electroencephalographic alpha band activity during general anesthesia","volume":"134","author":"Obert","year":"2022","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bja.2025.07.051_bib32","first-page":"701","article-title":"Always assess the raw electroencephalogram: why automated burst suppression detection may not detect all episodes","volume":"139","author":"Fleischmann","year":"2022","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bja.2025.07.051_bib33","doi-asserted-by":"crossref","first-page":"176","DOI":"10.17085\/apm.2016.11.2.176","article-title":"A comparison of oxycodone and fentanyl in the management of early postoperative pain and for patient-controlled analgesia after total abdominal hysterectomy","volume":"11","author":"Seo","year":"2016","journal-title":"Anesth Pain Med"},{"key":"10.1016\/j.bja.2025.07.051_bib34","article-title":"Population pharmacokinetic-pharmacodynamic model of dexmedetomidine in elderly patients undergoing sedation after abdominal aortic surgery","volume":"92","author":"Ber","year":"2023","journal-title":"J Med Sci"},{"key":"10.1016\/j.bja.2025.07.051_bib35","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1093\/bja\/aeq081","article-title":"Analysis of pharmacodynamic interaction of sevoflurane and propofol on bispectral index during general anaesthesia using a response surface model","volume":"104","author":"Diz","year":"2010","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bja.2025.07.051_bib36","doi-asserted-by":"crossref","first-page":"i46","DOI":"10.1093\/bja\/aev213","article-title":"The ageing brain: age-dependent changes in the electroencephalogram during propofol and sevoflurane general anaesthesia","volume":"115","author":"Purdon","year":"2015","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bja.2025.07.051_bib37","doi-asserted-by":"crossref","DOI":"10.3389\/fnsys.2020.599962","article-title":"Age-related EEG features of bursting activity during anesthetic-induced burst suppression","volume":"14","author":"Kratzer","year":"2020","journal-title":"Front Syst Neurosci"},{"key":"10.1016\/j.bja.2025.07.051_bib38","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/j.clinph.2019.05.014","article-title":"EEG power spectral density under propofol and its association with burst suppression, a marker of cerebral fragility","volume":"130","author":"Touchard","year":"2019","journal-title":"Clin Neurophysiol"},{"key":"10.1016\/j.bja.2025.07.051_bib39","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1213\/ANE.0000000000005824","article-title":"Cognitive recovery by decade in healthy 40- to 80-year-old volunteers after anesthesia without surgery","volume":"134","author":"Baxter","year":"2022","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bja.2025.07.051_bib40","first-page":"799","article-title":"Intraoperative electroencephalography alpha-band power is a better proxy for preoperative low MoCA under propofol compared with sevoflurane","volume":"136","author":"Guessous","year":"2023","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bja.2025.07.051_bib41","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1399-6576.2004.00258.x","article-title":"Age-related effects in the EEG during propofol anaesthesia: age-related effects in the EEG","volume":"48","author":"Schultz","year":"2004","journal-title":"Acta Anaesthesiol Scand"},{"key":"10.1016\/j.bja.2025.07.051_bib42","doi-asserted-by":"crossref","first-page":"24","DOI":"10.3389\/fnsys.2017.00024","article-title":"Intraoperative frontal alpha-band power correlates with preoperative neurocognitive function in older adults","volume":"11","author":"Giattino","year":"2017","journal-title":"Front Syst Neurosci"},{"key":"10.1016\/j.bja.2025.07.051_bib43","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1213\/ANE.0000000000004190","article-title":"Feasibility and rationale for incorporating frailty and cognitive screening protocols in a preoperative anesthesia clinic","volume":"129","author":"Amini","year":"2019","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bja.2025.07.051_bib44","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1002\/gps.5104","article-title":"Predicting postoperative delirium severity in older adults: the role of surgical risk and executive function","volume":"34","author":"Lindroth","year":"2019","journal-title":"Int J Geriatr Psychiatry"},{"key":"10.1016\/j.bja.2025.07.051_bib45","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1111\/aas.14251","article-title":"Association of sleep and anaesthesia EEG biomarkers with preoperative MoCA score: a pilot study","volume":"67","author":"Touchard","year":"2023","journal-title":"Acta Anaesthesiol Scand"},{"key":"10.1016\/j.bja.2025.07.051_bib46","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1097\/ALN.0000000000003181","article-title":"Preoperative cognitive abnormality, intraoperative electroencephalogram suppression, and postoperative delirium: a mediation analysis","volume":"132","author":"Fritz","year":"2020","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bja.2025.07.051_bib47","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.bja.2020.06.054","article-title":"Comorbidity-dependent changes in alpha and broadband electroencephalogram power during general anaesthesia for cardiac surgery","volume":"125","author":"Kaiser","year":"2020","journal-title":"Br J Anaesth"}],"container-title":["British Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0007091225005021?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0007091225005021?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:19:03Z","timestamp":1784708343000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0007091225005021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":47,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["S0007091225005021"],"URL":"https:\/\/doi.org\/10.1016\/j.bja.2025.07.051","relation":{},"ISSN":["0007-0912"],"issn-type":[{"value":"0007-0912","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"EEG alpha power and delirium in the postanaesthesia care unit in older adults: the AlphaMax trial part 2 - effect of propofol infusion during emergence from desflurane anaesthesia\u2606","name":"articletitle","label":"Article Title"},{"value":"British Journal of Anaesthesia","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.bja.2025.07.051","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier Ltd on behalf of British Journal of Anaesthesia.","name":"copyright","label":"Copyright"}]}}