Post-operative cognitive dysfunction – A brief review

Abstract

Postoperative cognitive dysfunction (POCD) can be referred to as a mild but possibly long-lasting altered intellectual function occurring after surgery, which is more common in old age. It may last from a few hours to some months or may be permanent. Up to half of patients, young and old, have POCD within the first week after surgery. Three months later, 10 to 15 percent of patients still have POCD. It's still unknown whether POCD results from some neurotoxic effect of anesthetic agents, or it simply reflects a preexisting cognitive (intellectual) problem in older adults. It has also been suggested that cognitive after-effects of surgery may result from an inflammatory process. The nature of the relationship is unclear; as multiple factors are likely involved. As the exact reasons are still not known, further research is needed to identify the patients and procedures at highest risk of POCD, and what steps can be taken to reduce that risk. Anesthesiologists should play a more active role in screening for reducing cognitive dysfunction before surgery.

Keywords

• Cognitive dysfunction
• general anesthesia
• post-operative
• opioids
• mini mental state examination