Perioperative delirium is an incredibly complex multifactorial syndrome, which despite a rapidly growing body of inquiry into its risk factors remains one of the most common complications of surgery and anesthesia. Acknowledging that most risk factors, such as underlying cognitive impairment and medical comorbidities, are unmodifiable in the short term, the causal contribution of anesthetic medications to postoperative delirium has proven difficult, and yet is crucial, to determine. In this issue of JAMA Surgery, Sieber and colleagues¹ describe an important and ultimately “negative” efficacy trial that investigated the potential contribution of the depth of anesthesia (and anesthetic dosages, which are inextricable) to postoperative delirium.

围手术期del妄是一种难以置信的复杂的多因素综合征，尽管对其危险因素的询问迅速增加，但仍然是外科手术和麻醉中最常见的并发症之一。认识到大多数风险因素（如潜在的认知障碍和医学合并症）在短期内无法改变，因此确定麻醉药物对术后del妄的因果关系已被证明是困难的，但至关重要的。在本期《JAMA外科手术》中，Sieber及其同事¹描述了一项重要且最终为“阴性”的功效试验，该试验研究了麻醉深度（和麻醉剂的剂量，这是不可分割的）对术后del妄的潜在贡献。