REVIEW ARTICLE
Neurology
doi: 10.25005/2074-0581-2024-26-3-439-451
POSTOPERATIVE COGNITIVE DYSFUNCTION: PREDICTORS, DIAGNOSIS, PREVENTION AND TREATMENT

O.N. YAMSHCHIKOV1,2, A.P. MARCHENKO1,2, S.A. EMELYANOV1,2, С.А. IGNATOVA1, N.A. MARCHENKO1

1Derzhavin Tambov State University, Medical Institute, Tambov, Russian Federation
2Kotovsk City Clinical Hospital, Kotovsk, Russian Federation

This review describes postoperative cognitive dysfunction (POCD), the incidence of which, according to the results of various studies, ranges from 4% to 65%. The problem of cognitive impairment in the postoperative period has recently received increasing attention from both researchers and practicing physicians of various specialties, especially anesthesiologists-resuscitators who treat these patients at all stages of the treatment process. The prevalence of POCD has yet to be studied in more depth. The relevance of this problem is associated with cognitive deficit, which affects the quality of life of patients, extended duration of inpatient treatment, and increasing frequency of severe life-threatening complications and death. Based on numerous studies, the article presents the main predictors of POCD and describes the main links in the pathogenesis of this condition. Neuropsychological testing is carried out to assess cognitive impairment before surgery and in the postoperative period. It allows for diagnosing this pathology and provides timely prevention and treatment of this condition. If predictors of cognitive dysfunction are identified, correction of the respective disorders is performed. Pharmacological agents are considered as prevention options. Patients with a high probability of POCD are offered neuroprotectors, antihypoxants, antioxidants, neuroplasticity stimulators, and non-steroidal anti-inflammatory drugs (NSAIDs). One of the promising drugs used for the prevention and treatment of POCD and postoperative delirium is dexmedetomidine, an alpha2-adrenergic receptor agonist, a drug with pleiotropic action (anxiolytic, sedative, sympatholytic, and analgesic). Data for this paper on postoperative cognitive disorders were collected from the electronic scientific databases PubMed, Elibrary, Cyberleninka for 2014-2023. This literature review clearly demonstrates the high prevalence of postoperative cognitive impairment, including postoperative delirium. The problem of maintaining and restoring higher mental functions in patients undergoing surgery is one of the global challenges of modern medicine

Keywords: Postoperative cognitive dysfunction, predictors of cognitive dysfunction, delirium, dexmedetomidine.

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Authors' information:

Yamshchikov Oleg Nikolayevich,
Doctor of Medical Sciences, Head of the Department of Hospital Surgery with a Course of Traumatology of Medical Institute, Derzhavin Tambov State University; Chief Physician, Kotovsk City Clinical Hospital
ORCID ID: 0000-0001-6825-7599
SPIN: 9115-2547
E-mail: yamschikov.oleg@yandex.ru

Marchenko Aleksandr Petrovich,
Candidate of Medical Sciences, Associate Professor of the Department of Hospital Surgery with a Course of Traumatology of Medical Institute, Derzhavin Tambov State University; Head of the De partment of Anesthesiology and Intensive Care, Kotovsk City Clinical Hospital
ORCID ID: 0000-0002-9387-3374
SPIN: 9253-4117
E-mail: sashamarchen@mail.ru

Emelyanov Sergey Aleksandrovich,
Candidate of Medical Sciences, Associate Professor of the Department of Hospital Surgery with a Course of Traumatology of Medical Institute, Derzhavin Tambov State University; Deputy Chief Physician for Medical Affairs, Kotovsk City Clinical Hospital
ORCID ID :0000-0002-5550-4199
SPIN: 4368-8660
E-mail: cep_a@mail.ru

Ignatova Svetlana Alekseevna,
Resident Anesthesiologist-Resuscitator of the Department of Hospital Surgery with a Course of Traumatology of Medical Institute, Derzhavin Tambov State University
ORCID ID:0000-0003-4223-5038
E-mail: ignatowa.svet2015@ya.ru

Marchenko Nailya Aleksandrovna,
Student of the Medical Institute, Derzhavin Tambov State University
ORCID ID: 0000-0002-6612-794X E-mail: marchenkonaily@gmail.com

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipmen

Conflicts of interest: No conflict

Address for correspondence:

Yamshchikov Oleg Nikolayevich
Doctor of Medical Sciences, Head of the Department of Hospital Surgery with a Course of Traumatology of Medical Institute, Derzhavin Tambov State University; Chief Physician, Kotovsk City Clinical Hospital

392000, Russian Federation, Tambov, Internatsionalnaya str., 33

Tel.: +7 (915) 8695057

E-mail: yamschikov.oleg@yandex.ru

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