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01.12.2017 | Geriatric Anesthesia (S Akhtar, Section Editor) | Ausgabe 4/2017

Current Anesthesiology Reports 4/2017

Postoperative Cognitive Dysfunction

Zeitschrift:
Current Anesthesiology Reports > Ausgabe 4/2017
Autoren:
Valerie J. Page, Fiona C. Oglesby, Richard A. Armstrong
Wichtige Hinweise
This article is part of the Topical Collection on Geriatric Anesthesia

Abstract

Purpose of review

Postoperative cognitive dysfunction (POCD) is a poorly defined syndrome to describe cognitive impairment in patients following anaesthesia and surgery. This narrative POCD review outlines the relevant literature from animal and clinical studies published within the last 5 years with a focus on elderly patients.

Recent findings

Increasing age is a well-recognised risk factor for POCD, and in some patients, the resulting cognitive impairment will persist. The association with postoperative delirium is unclear. The evidence supports that neuroinflammation as a result of surgical stress is a key factor in POCD, and patients with pre-existing cognitive impairment are particularly at risk. Clinical research consists of conflicting results with regard to the anaesthetic technique and small hypothesis-generating single-site studies regarding biomarkers and potential therapies.

Summary

A definition and diagnostic criteria for POCD are urgently needed to inform research into the pathophysiology, identification of patients at risk and anaesthetic management designed to improve patient outcomes. We conclude with a recommendation for current clinical practice.

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