Key result
Adverse perioperative factors, such as neurotoxic anesthetics and neuroinflammation, can potentially cause postoperative cognitive dysfunction.
Why the study?
Postoperative cognitive dysfunction can complicate recovery even after minimally invasive procedures and significantly challenge quality of life, prompting a review of its etiology, pathogenesis, and current perspectives.
Postoperative cognitive dysfunction is a multifactorial complication of surgery and anesthesia, driven by neuroinflammation and cerebral blood flow changes, requiring further research for effective prevention and pharmacotherapy.
Early POCD may signal later impairment after even minor surgery; prospective trials needed before changing perioperative practice.
Impairment of higher mental functions can complicate the course of the postoperative period even after short and minimally invasive, including laparoscopic, surgical procedures. Postoperative cognitive dysfunction significantly challenges patients’ quality of life, negating real success of surgical intervention and anesthetic support. In some cases, early postoperative cognitive dysfunction may be one of the main predictors of persistent cognitive impairment. The purpose of the review. To contemplate etiology, pathogenesis and the current perspective of postoperative cognitive dysfunction. We analyzed 96 publications in various databases (PubMed, Medline, RSCI and others), including 67 papers published over the past 5 years. The review provides an overview of current definitions and classification of postoperative cognitive dysfunction, data on the prevalence, polyethyology and risk factors, potential impact of the type of anesthesia and surgical intervention on the development of postoperative cognitive dysfunction. Various pathogenetic mechanisms of higher mental functions impairment alongside with available effective pharmacotherapies to correct them were considered. Conclusion. Numerous adverse factors of the perioperative period, such as neurotoxic effects of general anesthetics, neuroinflammation in response to operational stress and surgical trauma, impaired autoregulation of the cerebral blood flow, imperfect oxygen homeostasis, interactions of neurotransmitter, etc., can potentially cause postoperative cognitive dysfunction. Further deeper insights into etiology and pathogenesis of early postoperative cognitive dysfunction are relevant and necessary to improve prevention strategies and identify most effective pharmacotherapies to correct such disorders.
No takes yet. Share an insight, caveat, or question.
Неймарк et al. (2023) conducted a review in Postoperative cognitive dysfunction. Adverse perioperative factors, such as neurotoxic anesthetics and neuroinflammation, can potentially cause postoperative cognitive dysfunction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: