The role of anesthesia in peri‑operative neurocognitive disorders: Molecular mechanisms and preventive strategies

Ran Li; Yun Zhang; Qinxin Zhu; Yili Wu; Weihong Song

doi:10.1016/j.fmre.2023.02.007

The role of anesthesia in peri‑operative neurocognitive disorders: Molecular mechanisms and preventive strategies

Fundam Res. 2023 Feb 24;4(4):797-805. doi: 10.1016/j.fmre.2023.02.007. eCollection 2024 Jul.

Authors

Ran Li¹, Yun Zhang², Qinxin Zhu¹, Yili Wu^{1

3}, Weihong Song^{1

2

3}

Affiliations

¹ The Second Affiliated Hospital and Yuying Children's Hospital, Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Wenzhou Medical University, Wenzhou 325035, China.
² The National Clinical Research Center for Geriatric Disease, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
³ Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou 325000, China.

Abstract

Peri-operative neurocognitive disorders (PNDs) include postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). Children and the elderly are the two populations most vulnerable to the development of POD and POCD, which results in both high morbidity and mortality. There are many factors, including neuroinflammation and oxidative stress, that are associated with POD and POCD. General anesthesia is a major risk factor of PNDs. However, the molecular mechanisms of PNDs are poorly understood. Dexmedetomidine (DEX) is a useful sedative agent with analgesic properties, which significantly improves POCD in elderly patients. In this review, the current understanding of anesthesia in PNDs and the protective effects of DEX are summarized, and the underlying mechanisms are further discussed.

Keywords: Alzheimer's disease; Dexmedetomidine; General anesthesia; Peri-operative neurocognitive disorders; Postoperative cognitive dysfunction; Postoperative delirium.

Publication types

Review