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Postoperative neurocognitive disorders

대한마취과학회지 2021년 74권 1호 p.15 ~ 22
Tasbihgou Setayesh Reza, Absalom Anthony Ray,
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 ( Tasbihgou Setayesh Reza ) - University of Groningen University Medical Center Groningen Department of Anesthesiology
 ( Absalom Anthony Ray ) - University of Groningen University Medical Center Groningen Department of Anesthesiology

Abstract


A decline in cognitive function is a frequent complication of major surgery. Postoperative cognitive impairments have generally been divided into short- (postoperative delirium) and long-term disturbances (postoperative cognitive dysfunction [POCD]). Long-term impairments are often subtle and overlooked. They need to be objectively assessed using neuropsychological tests to be diagnosed. Although POCD has been the subject of considerable research over the past decades, it remains uncertain why some patients do not return to preoperative levels of cognitive function. Surgery and anesthesia have both been implicated to play a role in POCD development, and certain patient-related factors, such as advanced age and low preoperative baseline cognitive function, have consistently been found to predict postoperative cognitive decline. This article will present an overview of POCD and its etiology and provide advice on possible strategies on its prevention.

키워드

Aged; Delirium; Frail elderly; Inflammation; Neurocognitive disorders; Perioperative care; Postoperative cognitive complications.

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