Trastorno neurocognitivo postoperatorio: una revisión de aspectos básicos.
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Published:
Dec 27, 2021
Keywords:
Disfunción cognitiva, cuidados posoperatorios, periodo posoperatorio, cirugía
Main Article Content
Abstract
Postoperative neurocognitive disorder is a condition known for several decades characterized by alteration of attention, language, perceptual function, motor function, memory, and learning related to the surgical act and the use of anesthesia. However, there is no standardized definition of the disorder and no delimitation of the criteria for diagnosis. This dysfunction is usually transitory and can persist for several years; generally, it mainly affects older adults who undergo prolonged surgical times. Current manuscripts mention that it should be diagnosed using standardized tests to assess cognitive impairment before and after the surgical procedure, with at least one follow-up within the first year after surgery.
Regarding treatment, drugs that act on the pathways proposed as pathophysiological mechanisms have been suggested, among which analgesics and antioxidants stand out.
Article Details
How to Cite
1.
Picón Jaimes YA, Lara-Ortega R, Padilla-Zambrano H, Ramos-Villegas Y, Quintana-Pájaro L, Andrade-López A, et al. Trastorno neurocognitivo postoperatorio: una revisión de aspectos básicos. . Rev Arg de Ter Int. [Internet]. 2021 Dec. 27 [cited 2024 Nov. 24];38. Available from: https://revista.sati.org.ar/index.php/MI/article/view/788
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References
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27. Karaman T, Karaman S, Doğru S, Tapar H, Şahin A, Süren M. Short-term and long-term effects of dexamethasone on cognitive dysfunction induced by sevoflurane in adult rats. Turk J Anaesthesiol Reanim. 2017;45(3):158–63.
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29. Cerqueira N, Oliveira EF, Gesto DS, Santos-Martins D, Moreira C, Moorthy HN, et al. Cholesterol biosynthesis: A mechanistic overview. Biochemistry. 2016;55(39):5483–506.
2. Tire Y, Aydoğan E, Sargın M, Kozanhan B. Assessment of postoperative cognitive dysfunction: Results from a survey of Turkish anaesthesiologists. Turk J Anaesthesiol Reanim. 2020;48(4):300–7.
3. Hollinger A, Rüst CA, Riegger H, Gysi B, Tran F, Brügger J, et al. Ketamine vs. haloperidol for prevention of cognitive dysfunction and postoperative delirium: A phase IV multicentre randomised placebo-controlled double-blind clinical trial. J Clin Anesth. 2021;68(110099):110099.
4. Ackenbom MF, Butters MA, Davis EM, Abebe KZ, Baranski L, Zyczynski HM. Incidence of postoperative cognitive dysfunction in older women undergoing pelvic organ prolapse surgery. Int Urogynecol J. 2021;32(2):433–42.
5. Needham MJ, Webb CE, Bryden DC. Postoperative cognitive dysfunction and dementia: what we need to know and do. Br J Anaesth. 2017;119:i115–25.
6. Paredes S, Cortínez L, Contreras V, Silbert B. Disfunción cognitiva postoperatoria a los 3 meses en adultos después de cirugía no cardíaca: una revisión sistemática cualitativa. Acta Anaesthesiol Scand. 2016; 60: 1043–1058.
7. Abildstrom H, Rasmussen LS, Rentowl P, et al. Cognitive dysfunction 1-2 years after non-cardiac surgery in the elderly. ISPOCD group. International Study of Post-Operative Cognitive Dysfunction. Acta Anaesthesiol Scand. 2000;44:1246–1251.
8. Evered LA, Silbert BS. Postoperative cognitive dysfunction and noncardiac surgery. Anesth Analg. 2018;127(2):496–505.
9. Kotekar N, Shenkar A, Nagaraj R. Postoperative cognitive dysfunction - current preventive strategies. Clin Interv Aging. 2018;13:2267–73.
10. Feinkohl I, Winterer G, Spies CD, Pischon T. Cognitive reserve and the risk of postoperative cognitive dysfunction. Dtsch Arztebl Int. 2017;114(7):110–7.
11. Lin X, Chen Y, Zhang P, Chen G, Zhou Y, Yu X. The potential mechanism of postoperative cognitive dysfunction in older people. Exp Gerontol. 2020;130(110791):110791.
12. Liu Y, Yin Y. Emerging roles of immune cells in postoperative cognitive dysfunction. Mediators Inflamm. 2018;2018:1–8.
13. Safavynia SA, Goldstein PA. The role of neuroinflammation in postoperative cognitive dysfunction: Moving from hypothesis to treatment. Front Psychiatry. 2018;9:752.
14. Zhang T, Leng Z, Liu W, Wang X, Yan X, Yu L. Suppressed expression of mitogen-activated protein kinases in hyperthermia induced defective neural tube. Neurosci Lett. (2015) 594:6–11. 10.1016/j.neulet.2015.03.046
15. Kapoor I, Prabhakar H, Mahajan C. Postoperative cognitive dysfunction. Indian J Crit Care Med. 2019;23(Suppl 2):S162–4.
16. Orhun G, Sungur Z, Koltka K, Savran Karadeniz M, Yavru HA, Gürvit H, et al. Comparison of epidural analgesia combined with general anesthesia and general anesthesia for postoperative cognitive dysfunction in elderly patients. Ulus Travma Acil Cerrahi Derg. 2020;26(1):30–6.
17. Gao Y, Liu L, Zhao B, Wang Y, Yu S, Wang H. Effect of general and non-general anesthesia on postoperative cognitive dysfunction. J Coll Physicians Surg Pak. 2020;30(4):407–11
18. Pappa M, Theodosiadis N, Tsounis A, Sarafis P. Pathogenesis and treatment of post-operative cognitive dysfunction. Electron Physician. 2017;9(2):3768–75.
19. Sturm H, Wildermuth R, Stolz R, Bertram L, Eschweiler GW, Thomas C, et al. Diverging awareness of postoperative delirium and cognitive dysfunction in German health care providers. Clin Interv Aging. 2019;14:2125–35
20. Devinney MJ, Mathew JP, Berger M. Postoperative delirium and postoperative cognitive dysfunction: Two sides of the same coin? Anesthesiology. 2018;129(3):389–91.
21. Borchers F, Spies CD, Feinkohl I, Brockhaus W-R, Kraft A, Kozma P, et al. Methodology of measuring postoperative cognitive dysfunction: a systematic review. Br J Anaesth. 2021;126(6):1119–27.
22. Murkin JM, Newman SP, Stump DA, Blumenthal JA. Statement of consensus on assessment of neurobehavioral outcomes after cardiac surgery. Ann Thorac Surg. 1995;59(5):1289–95.
23. Evered L, Silbert B, Knopman DS, Scott DA, DeKosky ST, Rasmussen LS, et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018. Br J Anaesth. 2018;121(5):1005–12.
24. Peng M, Wang Y-L, Wang F-F, Chen C, Wang C-Y. The cyclooxygenase-2 inhibitor parecoxib inhibits surgery-induced proinflammatory cytokine expression in the hippocampus in aged rats. J Surg Res. 2012;178(1):e1-8.
25. Zhu Y-Z, Yao R, Zhang Z, Xu H, Wang L-W. Parecoxib prevents early postoperative cognitive dysfunction in elderly patients undergoing total knee arthroplasty: A double-blind, randomized clinical consort study. Medicine (Baltimore). 2016;95(28):e4082.
26. Zhu Y, Yao R, Li Y, Wu C, Heng L, Zhou M, et al. Protective effect of celecoxib on early postoperative cognitive dysfunction in geriatric patients. Front Neurol. 2018;9:633.
27. Karaman T, Karaman S, Doğru S, Tapar H, Şahin A, Süren M. Short-term and long-term effects of dexamethasone on cognitive dysfunction induced by sevoflurane in adult rats. Turk J Anaesthesiol Reanim. 2017;45(3):158–63.
28. Valentin LS, Pereira VF, Pietrobon RS, Schmidt AP, Oses JP, Portela LV, et al. Effects of single low dose of dexamethasone before noncardiac and nonneurologic surgery and general anesthesia on postoperative cognitive dysfunction-A phase III double blind, randomized clinical trial. PLoS One. 2016;11(5):e0152308.
29. Cerqueira N, Oliveira EF, Gesto DS, Santos-Martins D, Moreira C, Moorthy HN, et al. Cholesterol biosynthesis: A mechanistic overview. Biochemistry. 2016;55(39):5483–506.