In their study, “Intravenous versus Volatile Anesthetic Effects on Postoperative Cognition in Elderly Patients Undergoing Laparoscopic Abdominal Surgery,” Li et al. reported no difference in the incidence of delayed neurocognitive recovery in patients undergoing laparoscopic abdominal surgery with general anesthesia using sevoflurane versus propofol. Their secondary outcome involved measuring biomarkers at five prespecified perioperative timepoints to assess their potential to predict delayed neurocognitive recovery. They found that the interleukin-6 concentration at 1 h after the start of surgery (Timepoint 3 [T3]) was significantly different between patients with and without delayed neurocognitive recovery. We have two points of discussion regarding this finding.

First, we wonder about the true significance of interleukin-6 at T3. Thirteen biomarkers were tested at five different timepoints, yielding 65 distinct data points. Testing this many variables increases the likelihood of achieving a “significant” P...

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