Relevant bibliographies by topics / Postoperative cognitive dysfunction

Academic literature on the topic 'Postoperative cognitive dysfunction'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "Postoperative cognitive dysfunction"

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Saksono, Awang Budi. "Postoperative Cognitive Dysfunction." Open Access Indonesian Journal of Medical Reviews 1, no. 3 (October 15, 2021): 41–43. http://dx.doi.org/10.37275/oaijmr.v1i3.38.

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The impact of general anesthesia on cognitive impairment is controversial and complex. A large body of evidence supports the association between exposure to surgery under general anesthesia and the development of delayed neurocognitive recovery in a subset of patients. Existing literature continues to debate whether these short-term effects on cognition can be attributed to anesthetic agents themselves or whether other variables are causative of the observed changes in understanding. Furthermore, there are conflicting data on the relationship between anesthesia exposure and the development of long-term neurocognitive disorders or incident dementia in the patient population with normal preoperative cognitive function. Patients with pre-existing cognitive impairment present a unique set of anesthetic considerations, including potential medication interactions, challenges with cooperation during assessment and non-general anesthesia techniques, and the possibility that pre-existing cognitive impairment may impart a susceptibility to further cognitive dysfunction.
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Saksono, Awang Budi. "Postoperative Cognitive Dysfunction." Open Access Indonesian Journal of Medical Reviews 1, no. 3 (August 30, 2021): 41–43. http://dx.doi.org/10.37275/oaijmr.v1i3.557.

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The impact of general anesthesia on cognitive impairment is controversial and complex. A large body of evidence supports the association between exposure to surgery under general anesthesia and the development of delayed neurocognitive recovery in a subset of patients. Existing literature continues to debate whether these short-term effects on cognition can be attributed to anesthetic agents themselves or whether other variables are causative of the observed changes in understanding. Furthermore, there are conflicting data on the relationship between anesthesia exposure and the development of long-term neurocognitive disorders or incident dementia in the patient population with normal preoperative cognitive function. Patients with pre-existing cognitive impairment present a unique set of anesthetic considerations, including potential medication interactions, challenges with cooperation during assessment and non-general anesthesia techniques, and the possibility that pre-existing cognitive impairment may impart a susceptibility to further cognitive dysfunction.
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Kapoor, Indu, Hemanshu Prabhakar, and Charu Mahajan. "Postoperative Cognitive Dysfunction." Indian Journal of Critical Care Medicine 23, S2 (June 1, 2019): 162–64. http://dx.doi.org/10.5005/jp-journals-10071-23196.

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Bogolepova, A. N. "Postoperative cognitive dysfunction." Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova 122, no. 8 (2022): 7. http://dx.doi.org/10.17116/jnevro20221220817.

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Hanning, C. D. "Postoperative cognitive dysfunction." British Journal of Anaesthesia 95, no. 1 (July 2005): 82–87. http://dx.doi.org/10.1093/bja/aei062.

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Page, Valerie J., Fiona C. Oglesby, and Richard A. Armstrong. "Postoperative Cognitive Dysfunction." Current Anesthesiology Reports 7, no. 4 (October 5, 2017): 380–86. http://dx.doi.org/10.1007/s40140-017-0238-1.

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Grape, S., P. Ravussin, A. Rossi, C. Kern, and L. A. Steiner. "Postoperative cognitive dysfunction." Trends in Anaesthesia and Critical Care 2, no. 3 (June 2012): 98–103. http://dx.doi.org/10.1016/j.tacc.2012.02.002.

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Berger, Miles, Jacob W. Nadler, Jeffrey Browndyke, Niccolo Terrando, Vikram Ponnusamy, Harvey Jay Cohen, Heather E. Whitson, and Joseph P. Mathew. "Postoperative Cognitive Dysfunction." Anesthesiology Clinics 33, no. 3 (September 2015): 517–50. http://dx.doi.org/10.1016/j.anclin.2015.05.008.

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Daiello, Lori A., Annie M. Racine, Ray Yun Gou, Edward R. Marcantonio, Zhongcong Xie, Lisa J. Kunze, Kamen V. Vlassakov, Sharon K. Inouye, and Richard N. Jones. "Postoperative Delirium and Postoperative Cognitive Dysfunction." Anesthesiology 131, no. 3 (September 1, 2019): 477–91. http://dx.doi.org/10.1097/aln.0000000000002729.

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Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Postoperative delirium and postoperative cognitive dysfunction share risk factors and may co-occur, but their relationship is not well established. The primary goals of this study were to describe the prevalence of postoperative cognitive dysfunction and to investigate its association with in-hospital delirium. The authors hypothesized that delirium would be a significant risk factor for postoperative cognitive dysfunction during follow-up. Methods This study used data from an observational study of cognitive outcomes after major noncardiac surgery, the Successful Aging after Elective Surgery study. Postoperative delirium was evaluated each hospital day with confusion assessment method–based interviews supplemented by chart reviews. Postoperative cognitive dysfunction was determined using methods adapted from the International Study of Postoperative Cognitive Dysfunction. Associations between delirium and postoperative cognitive dysfunction were examined at 1, 2, and 6 months. Results One hundred thirty-four of 560 participants (24%) developed delirium during hospitalization. Slightly fewer than half (47%, 256 of 548) met the International Study of Postoperative Cognitive Dysfunction-defined threshold for postoperative cognitive dysfunction at 1 month, but this proportion decreased at 2 months (23%, 123 of 536) and 6 months (16%, 85 of 528). At each follow-up, the level of agreement between delirium and postoperative cognitive dysfunction was poor (kappa less than .08) and correlations were small (r less than .16). The relative risk of postoperative cognitive dysfunction was significantly elevated for patients with a history of postoperative delirium at 1 month (relative risk = 1.34; 95% CI, 1.07–1.67), but not 2 months (relative risk = 1.08; 95% CI, 0.72–1.64), or 6 months (relative risk = 1.21; 95% CI, 0.71–2.09). Conclusions Delirium significantly increased the risk of postoperative cognitive dysfunction in the first postoperative month; this relationship did not hold in longer-term follow-up. At each evaluation, postoperative cognitive dysfunction was more common among patients without delirium. Postoperative delirium and postoperative cognitive dysfunction may be distinct manifestations of perioperative neurocognitive deficits.
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Devinney, Michael J., Joseph P. Mathew, and Miles Berger. "Postoperative Delirium and Postoperative Cognitive Dysfunction." Anesthesiology 129, no. 3 (September 1, 2018): 389–91. http://dx.doi.org/10.1097/aln.0000000000002338.

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Dissertations / Theses on the topic "Postoperative cognitive dysfunction"

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Rasmussen, Lars Simon. "Postoperative cognitive dysfunction : incidence, risk factors, and correlation with biochemical markers for brain damage /." Københavns : Lægeforeningens Forlag, 2007. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=016143662&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.

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Shoair, Osama. "Risk Factors for Postoperative Cognitive Dysfunction in Older Adults Undergoing Major Noncardiac Surgery." VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/503.

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Background: Postoperative cognitive dysfunction (POCD) is a deterioration in cognitive function that occurs after surgery as measured by neuropsychological tests. The purpose of this study was to determine the incidence and risk factors for POCD in older adults three months after major noncardiac surgery. Methods: This is a prospective study of patients aged 65 years and older who underwent major noncardiac surgery. Patients’ cognitive function was assessed before and three months after surgery using a computerized neurocognitive battery. Blood samples were withdrawn from patients before surgery to identify patients with high level of C-reactive protein (CRP), and patients who had the apolipoprotein-E4 (ApoE4) allele, as potential inflammatory and genetic biomarkers for POCD, respectively. A nonsurgical control group, that is similar to patients in age, education level, and computer familiarity, was recruited to adjust for learning effects from repeated administration of neurocognitive tests. Patients were classified as having POCD if they had less than -1.96 in the individual Z-scores of two or more tests or in the composite Z-score. Results: A total of 69 patients and 54 controls completed the study. The mean age for patients was 71 ± 5.4 (65–88) years old and 66.7% of them were females. The majority of patients (78.3%) had above high school education. There was no difference between the surgical and nonsurgical groups in demographics except for age which was marginally higher in the nonsurgical group [73 ± 6.3 (65-92)]. The incidence of POCD was 15.9% three months after surgery. Multivariable logistic regression showed that carrying the ApoE4 allele (OR = 4.74, 95% CI = 1.09 – 22.19), using one or more highly anticholinergic or sedative-hypnotic drugs at home prior to surgery (OR = 5.64, 95% CI = 1.35 – 30.22), and receiving sevoflurane for anesthesia (OR = 6.43, 95% CI = 1.49 – 34.66) were risk factors for POCD. Conclusion: The incidence of POCD in older adults is 15.9% three months after major noncardiac surgery. Risk factors for POCD were carrying the ApoE4 allele, using one or more highly anticholinergic or sedative-hypnotic drugs at home prior to surgery, and receiving sevoflurane for anesthesia.
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Terrando, Niccolò. "Inflammatory signalling in postoperative cognitive dysfunctions." Thesis, Imperial College London, 2009. http://hdl.handle.net/10044/1/9019.

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Major surgeries, such as cardiac or orthopaedic procedures in particular, expose the patient to extensive trauma, blood loss, and tissue injury; all of these factors effectively modulate the immune system to ultimately trigger an inflammatory response. Postoperative cognitive dysfunction (POCD), the condition being characterized by impairment of short and long-term memory, is one of common complicates following surgery. Recently, our data have demonstrated that neuroinflammation and microglia activation in the hippocampus following surgery are associated with cognitive decline. The aim of this thesis is to investigate the inflammatory signaling pathways specifically involved with POCD, with a particular interest between systemic inflammation and local inflammation in the brain following surgery. The data presented in this thesis introduce the general concepts and the involvement of inflammation in the etiology of cognitive dysfunctions using a mouse model of POCD. Upon the identification of specific pro-inflammatory markers both systemically and centrally and the delineation of the time course of events that characterize the inflammatory response following aseptic orthopaedic surgery, I describe how specific cellular signal pathways interact, mediate, and sustain this response. Following an initial non-specific approach using a general anti-inflammatory compound to identify whether inflammation plays a role in this scenario, I have exploited this model into a wide range of knockouts animals in the attempt of identifying specific signaling mechanisms and upstream receptors that mediate the behavioral abnormality following surgery. In order to achieve this, I have compared the inflammatory events after aseptic surgery with the response after a defined infectious stimulus, to ultimately joint the two in the context of a postoperative complication. In conclusion, inflammation clearly plays a pivotal role in mediating physiological as well as behavioral changes after surgery and infection. This thesis has started to unmask the signaling pathways involved with surgery and how anti-cytokine therapy can potentially ameliorate the associated cognitive dysfunction.
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Jemander, Joel, and Bergqvist Lina Ripoll. "Anestesidjup och anestesiduration hos elektiva ortopediska patienter som upplevt påverkan på kognitiv funktion postoperativt." Thesis, Luleå tekniska universitet, Omvårdnad, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-74715.

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Abstrakt Bakgrund: Forskning visar att generell anestesi kan bidra till kognitiv dysfunktion postoperativt. En alltför djup anestesi och/eller en lång duration av anestesi är två faktorer som kan inverka på kognitionen med besvär såsom minnesproblem och koncentrationssvårigheter. Anestesisjuksköterskans roll är att individanpassa anestesin för att inte orsaka för djup anestesi och därmed har det blivit alltmer vanligt att monitorera anestesidjupet för att minska på onödigt lidande för patienten. Syfte: Syftet är att kartlägga anestesidjup och anestesiduration  hos patienter med självskattad  kognitiv svikt efter elektiv ortopedisk operation. Metod: För att kartlägga detta valdes en retrospektiv observationsstudie med tvärsnittsdesign med insamlad data från kvalitetsregister. Resultat: Av 920 patienter var det 116 patienter som uppgav kognitiv dysfunktion dag 1 postoperativt och upp till över 16 dagar postoperativt med  ett genomsnittsvärde på 37,7 i entropy och 104,4 minuter i anestesiduration. Slutsats: Desto längre duration av anestesin och ju djupare anestesi desto mer kognitiv påverkan postoperativt. Anestesidjupsmonitorering bör användas mer frekvent och önskvärt är att bedöma kognition preoperativt med ett mätinstrument för att kunna se om skillnad finns postoperativt.
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Vacas, Susana Rodrigues. "Undrestanding postoperative cognitive dysfunction: novel insights." Doctoral thesis, 2014. http://hdl.handle.net/10362/13251.

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ABSTRACT: Background: Sleep is integral to biological function and sleep disruption can result in both physiological and psychological dysfunction. The acute cognitive consequences of sleep loss has been an active field of recent investigation, evidence suggests that sleep disruption in critically ill older adults can result in acute decrements in cognitive functioning. Surgery activates the innate immune system, inducing neuroinflammatory changes that interfere with cognition. The fact that patients with sleep disorders have an increased likelihood of exhibiting postoperative delirium encourages us to investigate the contribution of perioperative SF to the neuroinflammatory and cognitive responses of surgery. Methods: The effects of 24h sleep fragmentation (SF) and surgery were explored on adult C57BL/6J male mice. SF procedure started at 7 am with the home-cages being placed on a large platform orbital shaker cycled every 120 seconds (30 sec on/90 sec off). This procedure lasted for 24h. Stabilized tibia fracture was performed either before or after the 24h SF procedure. Separate cohorts of mice were tested for systemic and hippocampal inflammation and cognition. Results: Twenty-four hours of SF induced non-hippocampal memory dysfunction and increase in systemic IL-6. SF and surgery caused hippocampal-dependent memory impairment, although memory impairment was not exacerbated by combining SF with surgery. One day after either SF or surgery there was a significant increase in IL6 mRNA and TNF-alpha mRNA. These increments were more pronounced when either pre or post operative SF was combined with surgery. Conclusions: We show that while SF and surgery can independently produce significant memory impairment, perioperative SF significantly increased hippocampal inflammation without further cognitive impairment. The dissociation between neuroinflammation and cognitive decline may relate to our use of a sole memory paradigm that does not capture other aspects of cognition, especially learning.
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Rito, Ana Sofia Costa Gomes Manta. "Disfunção Cognitiva no Pós-operatório no Idoso." Master's thesis, 2018. http://hdl.handle.net/10316/82132.

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Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina
Este artigo de revisão tem como objetivo fornecer uma detalhada atualização dos estudos realizados sobre o efeito que uma intervenção cirúrgica pode ter no declínio da função cognitiva do idoso.A Disfunção Cognitiva pós-operatória (DCPO) é uma complicação cirúrgica e anestésica, cuja prevalência está a aumentar, principalmente na população idosa, emergindo como um problema de saúde pública. Apesar da crescente melhoria de cuidados peri-operatórios, continua a estar comumente associada a perda de memória e capacidade funcional resultando num aumento do período de internamento pós-operatório e dos custos associados aos cuidados de saúde.Embora já de longa data esteja referido na literatura médica o declínio cognitivo no idoso pós-cirurgia, continua a ser uma entidade sem definição e diagnóstico estabelecidos. A DCPO é um síndrome definido por uma queda na performance dos diversos testes neuropsicológicos realizados no período pré-operatório para o período pós-operatório.O seu mecanismo fisiopatológico não está ainda esclarecido, no entanto, a maioria dos estudos sugere que a exacerbação de uma resposta inflamatória ao stress cirúrgico e lesão cerebral estejam envolvidas. A importância de determinar quais os biomarcadores e fatores de risco desta disfunção reside na identificação dos doentes de elevado risco de forma a atuar preventivamente.Apesar de ainda não ter sido identificada nenhuma terapêutica ideal, várias medidas preventivas têm sido alvo de estudo de forma a diminuir a morbilidade e mortalidade e também promover uma melhor qualidade de vida. Assim, uma assistência adicional irá ser necessária a estes doentes pois a sua memória e outros domínios cognitivos vão estar francamente diminuídos impossibilitando-os de tomar decisões e realizar as suas atividades de vida diárias como antes.
The aim of this article is to provide a detailed and updated review on the studies about the effect that a surgical intervention can have on the elderly cognitive function. Post-operative Cognitive Dysfunction (POCD) is a surgical and anesthetic complication with growing prevalence, mainly in the elderly. Therefore, results in a public health issue. Although perioperative care is increasingly better it remains as a common complication. It is associated with memory loss and functional incapacity, resulting in prolonged hospitalization and higher health care costs. Although a cognitive decline in the elderly as a consequence of surgery has been reported in recent literature, its definiton and diagnose remain blurry. POCD is considered a syndrome defined by a lower performance on neuropsychological tests taken after surgery when compared to before surgery. Its fisiopathological mecanisms are also still uncertain. However, most studies suggest inflammatory response to surgical trauma and neuronal damage to have a pivotal role in its development. It is of high importance to determine this dysfunction’s predictive biomarkes and risk factors so high-risk patients are identified and preventive measures are promptly taken. Whereas an ideal therapy is not yet defined, prevention has recently been the target in investigation, in order to reduce morbidity and mortality and improve life quality. So, additional care will be needed to this group of patients whose cognitive functions will be diminished impairing their decision making and daily activities.
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Scott, Julia Erin. "Cognitive and psychological problems after total joint replacement in older adults." Thesis, 2017. http://hdl.handle.net/2440/119693.

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Total joint replacement (TJR) of the hip or knee is a major elective procedure that is frequently performed in older adults to treat end-stage osteoarthritis. It is generally considered to be a highly successful procedure because it significantly reduces the pain and disability caused by severe arthritis, and allows people to resume many of their everyday activities. However, there is also research to suggest that older patients may be susceptible to cognitive and psychological problems following TJR. Research investigating cognitive and psychological outcomes following TJR has provided mixed results, making it difficult to draw conclusions to inform clinical practice. While some studies have reported evidence of postoperative cognitive dysfunction (POCD) after TJR, others have not. Similarly, the reported rates of delirium after TJR have varied enormously (0% to 82%). In addition, estimates of the prevalence of clinically significant cases of depression and anxiety among TJR patients range from very high (i.e., 85-95%) to rates that are comparable to the general population. It is also unclear whether TJR has an impact on the levels of depression and anxiety that are reported by patients. The current thesis examined the cognitive and psychological outcomes of persons undergoing TJR surgery in order to clarify the risk of these problems in this patient population. To this end, three meta-analyses (Chapters 3-5) were conducted to evaluate the risk of cognitive and psychological problems following TJR: one examined POCD, another delirium, and one depression and anxiety. Lastly, a clinical study was conducted (Chapter 6) to address the outstanding issues within the POCD literature revealed by these reviews. Study 1 meta-analysed research that examined cognition pre- and post TJR. Data were categorised according to the cognitive domain that was assessed (e.g. memory, attention, executive function), follow-up interval (pre-discharge, 3 to 6 months post- surgery) and study design (single TJR group repeated measures, TJR and Control group repeated measures). Unfortunately, the incidence of POCD could not be determined because the studies did not use comparable definitions of POCD. Furthermore, limited conclusions could be drawn, largely because practice effects were generally not adequately controlled for. Overall, this meta-analysis revealed the need for methodologically rigorous research that controls for repeat testing confounds and uses a theoretically and statistically defensible definition of cognitive decline to investigate the incidence and severity of POCD after TJR. The second meta-analysis (Study 2) investigated the incidence of delirium after TJR, and whether differences in sample characteristics (e.g. hip vs knee, general vs regional anaesthesia) and study methodology (e.g. measure, assessment interval) contributed to the variability in the incidence rates reported by different studies. Delirium was found to occur in approximately one in six patients following TJR, but the variability in findings proved difficult to explain. Study 3 meta-analysed the research that examined depression and anxiety symptoms pre- and post-TJR. This study examined the prevalence of clinically significant levels of depression and anxiety in TJR patients, and changes in these symptoms pre- to post-surgery. Data were grouped and analysed according to the length follow-up interval. Although only limited data were available, a high proportion of TJR patients appeared to experience clinically significant levels of depression and anxiety pre- and early post-surgery. Modest decreases in symptoms were observed after surgery, but were unlikely to reflect clinically significant change. Once again, this study highlighted the fact that few studies have used a control group. Lastly, a clinical study (Study 4) was designed to overcome the limitations in previous research identified in Study 1 by including a control group and using standardised regression-based statistical methodology to reduce the confounding effects of repeat testing (practice effects, measurement error and regression to the mean) and to provide a statistically defensible definition of POCD. In addition, this study investigated whether POCD was related to cognitive reserve, which refers to individual differences in cognitive abilities that may protective against brain damage. Cognitive reserve has often been used to explain the lack of a clear relationship between brain pathology and the resulting symptoms, but has not yet been investigated in the context of POCD after TJR. TJR and matched healthy control groups were recruited, and cognitive functioning was assessed using a battery of tests both pre- and post-surgery (6 months). Other variables that may have affected cognitive performance were also assessed (e.g. demographics, medical history, pain, psychological distress). This study found minimal evidence of POCD six months after TJR, with patients only experiencing significant decline in their performance on a single test. Although preliminary, this suggests that patients who undergo TJR have good cognitive outcomes post-surgery. Although at odds with the findings of many previous studies, it highlights the importance of controlling for repeated testing by using a control group and appropriate statistical techniques (standardised regression-based statistics). Whether cognitive reserve was protective against POCD could only be explored to a limited degree because TJR patients only showed greater pre- to post-surgery decline on one task when compared to controls. Although cognitive reserve and performance on this task were not related, reserve predicted cognitive change among those TJR patients achieved the greatest improvement and greatest decline pre- to post-surgery, suggesting that cognitive reserve is related to better cognitive recovery post-surgery among a subset of patients. It remains to be seen whether cognitive reserve would better predict POCD in a sample with more pronounced cognitive dysfunction. Overall, this thesis provides a summary of the literature to date on cognitive and psychological outcomes after TJR in the elderly. In addition, this thesis has addressed some outstanding questions that remain regarding POCD. The clinical implications of these findings for patients who undergo TJR are discussed, and recommendations for future research are made.
Thesis (MPsych (Clinical) and Ph.D.) -- University of Adelaide, School of Psychology, 2017.
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Books on the topic "Postoperative cognitive dysfunction"

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Dodds, Chris, Chandra M. Kumar, and Frédérique Servin. Cognitive dysfunction and sleep disorders. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.003.0014.

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Cognitive dysfunction is largely a problem in the elderly, but it can occur at any age. The two major presentations, delirium and postoperative cognitive dysfunction (POCD), are compared. Risks for delirium are explored; key points from the patient’s history and possible ways to ameliorate the onset are then reviewed. The presentation of POCD is described, and the lack of our understanding of its causes is highlighted. Known triggers such as centrally active anticholinergic drugs or pain are identified. Current thinking in the inflammatory responses within microglia and astrocytes is summarized. Sleep in the elderly is contrasted with that in younger persons, and the main stages of sleep, SWS and REM, described. The impact and importance of the effects that surgery/anaesthesia has on sleep stages is reviewed. Obstructive sleep apnoea is described, including its effect on the safety of anaesthesia and recovery. Periodic limb movement disorders and early Parkinson disease are described.
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Ash, Simon A., and Donal J. Buggy. Outcomes of anaesthesia. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0039.

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Prevailing attitudes and conviction maintain that anaesthetic management, while ensuring safety, analgesia, and comfort perioperatively, has little influence on long-term patient outcomes. Gradually accumulating evidence is challenging this conventional wisdom, suggesting that choice of anaesthetic technique and perioperative management may, on the contrary, exert previously unrecognized long-term influences. This chapter seeks to review topical aspects of anaesthesia management which may influence postoperative patient outcomes. These include cardiovascular and pulmonary outcomes, surgical site infection, blood transfusion, perioperative glycaemic control, cancer recurrence, the development of chronic persistent pain, and postoperative cognitive dysfunction.
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Dodds, Chris, Chandra M. Kumar, and Frédérique Servin. Day-case anaesthesia in the elderly. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.003.0005.

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Successful outcome from day surgery depends on good preoperative preparation, education of patients, day-surgery pathways, informed decisions regarding planned procedures, and postoperative care. Day surgery is widely accepted as the default position for the vast majority of patients requiring surgery, with inpatient stay chosen only by exclusion. Day surgery remains a good choice in the elderly, subject to appropriate home care after surgery. Patients should be assessed sufficiently ahead of the surgery to allow preparation, management of associated chronic diseases, and optimization. General anaesthesia may be associated with higher incidence of postoperative cognitive dysfunction, and it should be avoided as much as possible. Regional anaesthesia is the preferred choice when applicable because it provides good postoperative analgesia. Spinal anaesthesia is useful, but it can be associated with delayed discharge. A multimodal approach to pain relief and management of postoperative nausea and vomiting (PONV) are essential because inadequate management can significantly delay discharge.
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Alvis, Bret D., and Christopher G. Hughes. Delirium. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0061.

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Delirium in the postoperative period, characterized by inattention, disorganized thinking, disorientation, and/or altered levels of consciousness within the first few days after surgery, has been associated with significant increases in hospital stay, functional decline, prolonged cognitive dysfunction, and mortality. It is underdiagnosed without routine assessments with validated tools such as the Confusion Assessment Method (CAM), the 4AT, the Confusion Assessment Method for Intensive Care Unit (CAM-ICU), or the Intensive Care Delirium Screening Checklist (ICDSC). Prevention strategies for postoperative delirium include multimodal pain control, judicious use of medications that affect the sensorium, including benzodiazepines and anticholinergics, maintenance of appropriate volume status, and optimization of the patient’s environment. In patients who develop delirium with severe agitation, antipsychotic and alpha-2 agonist medications may be useful. Because postoperative delirium occurs commonly and is associated with worse outcomes, an understanding of its disease process, risk factors, and management is essential for an anesthesiologist.
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Dodds, Chris, Chandra M. Kumar, and Frédérique Servin. Anaesthesia for the Elderly Patient (Oxford Anaesthsia Library). Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.001.0001.

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This book provides a timely and authoritative synopsis of the current state of anaesthesia and the elderly patient at a time when the challenge of caring for the growing numbers of elderly patients is probably the greatest faced by healthcare across the globe. The book reviews important developments in the understanding of clinical practice serving the elderly. It describes the need for anaesthesia to deliver ‘best care’ to the elderly, with the aim to maintain their independent living. It then details the key features of ageing and the effect these have on physiology and pharmacology. Specific aspects of practice, including preoperative assessment; day surgery; emergency surgery; anaesthesia for orthopaedic, urological, and gynaecological surgery, as well as major abdominal surgery; neurosurgery; and critical care. Emphasis is placed on managing postoperative care and cognitive dysfunction (POCD), with additional discussion of ethical issues and the law pertaining to the elderly patient. A new chapter reviews the challenges of treating elderly patients in non-theatre environments.
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Merry, Alan F., Simon J. Mitchell, and Jonathan G. Hardman. Hazards in anaesthetic practice: body systems and occupational hazards. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0045.

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“Can’t intubate, can’t oxygenate” crises and aspiration of gastric contents are important hazards in anaesthesia, and may result in the death of relatively young and healthy patients. Airway difficulties may manifest at the end of anaesthesia as well as at induction and are commoner in emergency departments and intensive care settings than during anaesthesia in operating rooms. Elements of poor management characterize the majority of airway complications. Emergency cricothyroidotomy performed by anaesthetists is associated with a high rate of failure. Other important hazards associated with anaesthesia may involve excessive or inadequate levels of oxygen or carbon dioxide in the blood, hypertension or hypotension, hypothermia or hyperthermia (including malignant hyperpyrexia), hypovolaemia, embolism of gas or thrombus, awareness, infection, and injury to the peripheral or central nervous system, or the eyes. Stroke and postoperative cognitive dysfunction may be particularly devastating for patients. These hazards are typically increased in low- and middle-income countries. The World Federation of Societies of Anaesthesiologists and the World Health Organization have endorsed international standards for a safe practice of anaesthesia, which are structured to reflect different levels of resource. The Lifebox Foundation seeks to improve the safety of surgery and anaesthesia in resource-constrained areas, notably by closing the substantial global gap in pulse oximetry. Several hazards are integral to the occupation of anaesthesia, including certain infections, increased rates of suicide, and medico-legal risks. In the end, the best way to mitigate these risks is through focusing on the safety of our patients.
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Lazar, Alina. Chronic Abdominal Pain in Children. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0019.

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Abdominal pain in the pediatric population is mostly functional. Patients with chronic abdominal pain (typically young females) have a high risk of anxiety, depression, and dysfunctional coping, which are also risk factors for postoperative pain and persistent postsurgical pain. In these patients, peripheral and central sensitization contribute to possible visceral hyperalgesia. When patients with chronic abdominal pain and visceral hyperalgesia undergo surgical procedures, perioperative pain can be difficult to treat. To manage the chronic pain of such patients, their complex biopsychosocial make-up should be considered. A comprehensive plan includes preventive and aggressive multimodal analgesia, adequate patient and parent education, realistic expectations, cognitive-behavioral therapy, and distraction and relaxation techniques.
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Book chapters on the topic "Postoperative cognitive dysfunction"

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Bharadwaj, Suparna, and Sriganesh Kamath. "Postoperative Cognitive Dysfunction." In Textbook of Neuroanesthesia and Neurocritical Care, 483–91. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-13-3387-3_34.

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Umholtz, Matthew, and Nader D. Nader. "Postoperative Delirium and Postoperative Cognitive Dysfunction." In General Anesthesia Research, 239–53. New York, NY: Springer US, 2019. http://dx.doi.org/10.1007/978-1-4939-9891-3_15.

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Foo, Irwin. "Postoperative Cognitive Dysfunction: Fact or Fiction?" In AAGBI Core Topics in Anaesthesia 2015, 114–26. Hoboken, NJ, USA: John Wiley & Sons, Inc., 2015. http://dx.doi.org/10.1002/9781118777442.ch9.

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Ida, Mitsuru, and Masahiko Kawaguchi. "Prevention and Treatment of Postoperative Delirium and Postoperative Cognitive Dysfunction." In Anesthesia and Neurotoxicity, 121–32. Tokyo: Springer Japan, 2017. http://dx.doi.org/10.1007/978-4-431-55624-4_8.

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Maekawa, Kengo. "Postoperative Cognitive Dysfunction After Cardiac Surgery and Neuroprotection." In Neuroanesthesia and Cerebrospinal Protection, 619–29. Tokyo: Springer Japan, 2015. http://dx.doi.org/10.1007/978-4-431-54490-6_54.

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Miyashita, Ryoichi. "Postoperative Cognitive Dysfunction After Noncardiac Surgery and Neuroprotection." In Neuroanesthesia and Cerebrospinal Protection, 631–39. Tokyo: Springer Japan, 2015. http://dx.doi.org/10.1007/978-4-431-54490-6_55.

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Bryden, Daniele. "Epidemiology, Mechanisms and Consequences of Postoperative Cognitive Dysfunction." In In Clinical Practice, 33–44. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-75723-0_3.

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Mitra, Jayanta Kumar, Priyank Tapuria, and Dona Saha. "Mental Status Dysfunction in ICU Postoperative Cognitive Impairment." In Onco-critical Care, 387–98. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-16-9929-0_33.

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Heir, Jagdev S. "Postoperative Cognitive Dysfunction as a Complication of Maxillofacial Surgery." In Perioperative Assessment of the Maxillofacial Surgery Patient, 617–23. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-58868-1_43.

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Ishida, Kazuyoshi, Atsuo Yamashita, Satoshi Yamashita, and Mishiya Matsumoto. "Present Clinical Status of Postoperative Cognitive Dysfunction in Cardiovascular Surgery." In Anesthesia and Neurotoxicity, 59–94. Tokyo: Springer Japan, 2017. http://dx.doi.org/10.1007/978-4-431-55624-4_5.

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Conference papers on the topic "Postoperative cognitive dysfunction"

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Еремина, О. В., Д. С. Каскаева, and С. С. Еремина. "Effect of citicoline in the prevention of postoperative cognitive dysfunction in coronary bypass surgery." In Научный диалог: Вопросы медицины. ЦНК МОАН, 2018. http://dx.doi.org/10.18411/spc-15-04-2018-09.

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Santos, Priscila, Daniel Godoy Pinto, Jussara Alves Celestino, and Marina Cisoto. "MentalPlus® as a Tool for Early Detection of Dementias." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.355.

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Introduction: The research’s objective is to identify early signs and symptoms of dementia through the MentalPlus® game. Dementias is a Neurocognitive Major Disorder, and as a diagnostic criterion, it is impaired in the areas of intricate attention, executive function, learning, memory, language, perceptomotor or social cognition. Method: MentalPlus® was created for timely evaluation and cognitive rehabilitation, considering the various diseases that cause cognitive dysfunction, such as dementia, heart problems, organic disorders, among others, in addition to surgical interventions and external factors. This instrument used to evaluate postoperative cognitive dysfunctions, which often affect elderly patients, confirms the validity and accessibility of the MentalPlus application. Results: Table 1 shows that the elderly in the group tested had statistically lower education than the control group (p < 0.001). Table 2 shows that for all domains of MentalPlus , on the hits part, the tested elderly group showed statistically lower values than the control group (p < 0.05), except only in the executive function (p = 0.231) and selective attention (p = 0.057), errors were also statistically higher in the elderly tested for almost all domains (p < 0.05), except in short-term memory (p = 0.206) and long-term memory (p = 0.179). At the same time, omissions were statistically higher in the elderly tested for all MP domains (p < 0.05). Conclusion: MentalPlus® identifies early signs of dementia in older people and is useful for the evaluator and the target audience, as it provides reliable data in a considerably short time.
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Krüger, T., O. Forkavets, S. Brefka, L. Conzelmann, C. Thomas, U. Mehlhorn, A. Liebold, C. Schlensak, and G. Eschweiler. "Postoperative Delirium and Cognitive Dysfunction after On- and Off-Pump CABG Surgery: A Prospective Trial in Aged Patients." In 49th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1705402.

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Mahajan, S., H. Bhagat, V. Grover, N. Panda, M. Mohanty, and N. Singla. "Comparison of pharmacological neuroprotection provided by propofol versus desflurane for long term postoperative cognitive dysfunction in patients undergoing surgery for aneurysmal subarachnoid hemorrhage." In 18th Annual Conference of Indian Society of Neuroanaesthesiology and Critical Care (ISNACC 2017). Thieme Medical and Scientific Publishers Private Ltd., 2017. http://dx.doi.org/10.1055/s-0038-1646235.

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Reports on the topic "Postoperative cognitive dysfunction"

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Huang, Ze-qing. Does propofol ameliorate occurrence of postoperative cognitive dysfunction after general anaesthesia? A protocol of systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review Protocols, April 2020. http://dx.doi.org/10.37766/inplasy2020.4.0103.

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hu, jichang, zhaohui yao, jingping yuan, and hongling yan. Comparative risk of anaesthetic drugs on postoperative cognitive dysfunction in elderly patients: a Bayesian network meta-analysis of randomized trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, July 2020. http://dx.doi.org/10.37766/inplasy2020.7.0008.

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Shen, Yan-Xi, You-Ping Chen, Hong-Cheng Zang, and Gang Shao. Evaluation of the Efficiency of Propofol versus Isoflurane Anesthesia Interventions in Treating Elderly Patients with Postoperative Cognitive Dysfunction: A Protocol for Systematic Review and Meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, September 2020. http://dx.doi.org/10.37766/inplasy2020.9.0042.

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Guo, Xinyi, Changxing Liu, Yue Wang, Dan Zhao, Yuan Min, Chong Zhang, Zhenjie Chai, Ting Ma, Yahui Huang, and Dong Yao. The effects of transcutaneous electrical acupoint stimulation on cognitive dysfunction and postoperative recovery in gastrointestinal tumours: a systematic review and meta-analysis of randomized controlled trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, October 2022. http://dx.doi.org/10.37766/inplasy2022.10.0080.

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Bhushan, Sandeep, Xin Huang, Zongwei Xiao, and Yuanqiong Duan. The impact of regional versus general anesthesia on postoperative neurocognitive outcomes in elderly patients undergoing hip fracture surgery: a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, June 2022. http://dx.doi.org/10.37766/inplasy2022.6.0110.

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Review question / Objective: To investigate the prevalence of postoperative delirium (POD) or postoperative cognitive dysfunction (POCD) between regional and general anesthesia in older patients undergoing hip fracture surgery. Condition being studied: About 1.6 million people suffer hip fractures each year globally1. The risk of hip fracture-related postoperative mortality within 30 days approximately was 8.2% in December 2020, up 1.5% from December 2016. Across the world, the aging population is growing, and a significant number of elderly patients are undergoing various kinds of orthopedic surgeries. Age as an important independent high-risk factor is associated with perioperative neurocognitive disorders (PNDs), which not only increases the rate but also causes a serious economic and social burden. One previous study investigated that between 2012 and 2016, the absolute total number of hip fractures in people aged 55 and older increased by about 4 times due to an aging population12. In addition, Bhushan et al. reported that along with the increasing aging of society, the incidence rate of POCD is 5% to 56% in the elderly over 55 years old after surgery morbidity and mortality but also causes a serious economic and social burden.
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Harris, Gregory, Brooke Hatchell, Davelin Woodard, and Dwayne Accardo. Intraoperative Dexmedetomidine for Reduction of Postoperative Delirium in the Elderly: A Scoping Review. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0010.

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Background/Purpose: Post-operative delirium leads to significant morbidity in elderly patients, yet there is no regimen to prevent POD. Opioid use in the elderly surgical population is of the most significant risk factors for developing POD. The purpose of this scoping review is to recognize that Dexmedetomidine mitigates cognitive dysfunction secondary to acute pain and the use of narcotic analgesia by decreasing the amount of norepinephrine (an excitatory neurotransmitter) released during times of stress. This mechanism of action also provides analgesia through decreased perception and modulation of pain. Methods: The authors developed eligibility criteria for inclusion of articles and performed a systematic search of several databases. Each of the authors initially selected five articles for inclusion in the scoping review. We created annotated literature tables for easy screening by co-authors. After reviewing the annotated literature table four articles were excluded, leaving 11 articles for inclusion in the scoping review. There were six level I meta-analysis/systematic reviews, four level II randomized clinical trials, and one level IV qualitative research article. Next, we created a data-charting form on Microsoft Word for extraction of data items and synthesis of results. Results: Two of the studies found no significant difference in POD between dexmedetomidine groups and control groups. The nine remaining studies noted decreases in the rate, duration, and risk of POD in the groups receiving dexmedetomidine either intraoperatively or postoperatively. Multiple studies found secondary benefits in addition to decreased POD, such as a reduction of tachycardia, hypertension, stroke, hypoxemia, and narcotic use. One study, however, found that the incidence of hypotension and bradycardia were increased among the elderly population. Implications for Nursing Practice: Surgery is a tremendous stressor in any age group, but especially the elderly population. It has been shown postoperative delirium occurs in 17-61% of major surgery procedures with 30-40% of the cases assumed to be preventable. Opioid administration in the elderly surgical population is one of the most significant risk factors for developing POD. With anesthesia practice already leaning towards opioid-free and opioid-limited anesthetic, the incorporation of dexmedetomidine could prove to be a valuable resource in both reducing opioid use and POD in the elderly surgical population. Although more research is needed, the current evidence is promising.
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