Postoperative delirium (POD) is a common and severe postoperative complication, with its incidence in non-cardiac surgical patients ranging from 10% to 60% based on surgical types. POD is generally recognized as a result of the interaction between individual susceptibility and external inducing factors, in which anesthetic modes and drug selection play a crucial role for anesthesiologists. Most studies have indicated that inhalation anesthesia may raise the risk of POD compared with propofol-based intravenous anesthesia, yet such research mainly focuses on sevoflurane, with few exploring the differences among various inhaled anesthetics in relation to POD. Based on existing basic and clinical research, desflurane shows advantages over sevoflurane and isoflurane, as it causes less neuronal damage and milder neuroinflammatory responses, facilitates faster postoperative consciousness recovery, improves awakening quality and shortens extubation time in patients. However, the current evidence on the potential effects of desflurane on POD is insufficient to draw definitive conclusions. This review systematically summarizes the latest basic and clinical research on desflurane and POD, aiming to clarify the potential effects of desflurane on POD and explore its underlying mechanisms. More rigorously designed and precisely evaluated studies are urgently needed to further verify the efficacy of desflurane in POD prevention and provide evidence-based references for the rational selection of inhaled anesthetics in clinical practice.
Ying Liu (Fri,) studied this question.