title: [Postoperative cognitive dysfunction. Possible neuronal mechanisms and practical consequences for clinical routine].
abstract: Postoperative cognitive dysfunction (POCD) presents as a long-lasting decline in cognitive function after a surgical procedure, predominantly occurring in elderly patients. The causes are most likely multifactorial with the exact mechanisms still unknown. Hypotheses of the causes of POCD are based on experimental evidence that anesthetics can impair mechanisms of learning and memory on a neuronal level and might lead to neurodegeneration. Additionally, surgery can result in neuroinflammation which could also underlie POCD. The most important strategy to avoid POCD is to maintain the patient's physiological homeostasis perioperatively. According to the presently available clinical studies recommendations in favor or against certain anesthesiological procedures cannot be given.
authors.affiliation: Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Deutschland. r.haseneder@lrz.tum.de
authors.forename: R
authors.initials: R
authors.lastname: Haseneder
authors.forename: E
authors.initials: E
authors.lastname: Kochs
authors.forename: B
authors.initials: B
authors.lastname: Jungwirth
mesh_terms: D000368:Aged; D000777:Anesthetics / Q000009:adverse effects; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology / Q000523:psychology*; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D008991:Monitoring, Physiologic; D019636:Neurodegenerative Diseases / Q000209:etiology / Q000473:pathology; D059408:Pain Management; D011183:Postoperative Complications / Q000473:pathology / Q000523:psychology*; D014176:Protein Biosynthesis; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D013569:Synapses / Q000187:drug effects
chemical_list: D000777:Anesthetics