Key result
Postoperative cognitive dysfunction occurs in 4% to 65% of surgical patients, driven by predictors like neuroinflammation and hypoxia, and may be mitigated by neuroprotective agents like dexmedetomidine.
Why the study?
The prevalence of postoperative cognitive dysfunction requires deeper study due to its impact on patient quality of life, hospital length of stay, and risk of severe complications and mortality.
This review highlights the high prevalence of postoperative cognitive dysfunction and discusses potential pharmacological strategies, including dexmedetomidine, for its prevention and management.
Answers are grounded in this paper and cite their sources.
Variable POCD incidence warrants vigilance in postoperative care; leaves open standardized definitions and cardiac-specific prospective data.
This review describes postoperative cognitive dysfunction (POCD), the incidence of which, according to the results of various studies, ranges from 4% to 65%. The problem of cognitive impairment in the postoperative period has recently received increasing attention from both researchers and practicing physicians of various specialties, especially anesthesiologists-resuscitators who treat these patients at all stages of the treatment process. The prevalence of POCD has yet to be studied in more depth. The relevance of this problem is associated with cognitive deficit, which affects the quality of life of patients, extended duration of inpatient treatment, and increasing frequency of severe life-threatening complications and death. Based on numerous studies, the article presents the main predictors of POCD and describes the main links in the pathogenesis of this condition. Neuropsychological testing is carried out to assess cognitive impairment before surgery and in the postoperative period. It allows for diagnosing this pathology and provides timely prevention and treatment of this condition. If predictors of cognitive dysfunction are identified, correction of the respective disorders is performed. Pharmacological agents are considered as prevention options. Patients with a high probability of POCD are offered neuroprotectors, antihypoxants, antioxidants, neuroplasticity stimulators, and non-steroidal anti-inflammatory drugs (NSAIDs). One of the promising drugs used for the prevention and treatment of POCD and postoperative delirium is dexmedetomidine, an alpha2-adrenergic receptor agonist, a drug with pleiotropic action (anxiolytic, sedative, sympatholytic, and analgesic). Data for this paper on postoperative cognitive disorders were collected from the electronic scientific databases PubMed, Elibrary, Cyberleninka for 2014-2023. This literature review clearly demonstrates the high prevalence of postoperative cognitive impairment, including postoperative delirium. The problem of maintaining and restoring higher mental functions in patients undergoing surgery is one of the global challenges of modern medicine Keywords: Postoperative cognitive dysfunction, predictors of cognitive dysfunction, delirium, dexmedetomidine.
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YAMSHCHIKOV et al. (2024) conducted a review in Postoperative cognitive dysfunction (POCD). Neuroprotective agents and anesthetic management (e.g., dexmedetomidine, cytoflavin) was evaluated. Postoperative cognitive dysfunction occurs in 4% to 65% of surgical patients, driven by predictors like neuroinflammation and hypoxia, and may be mitigated by neuroprotective agents like dexmedetomidine.
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