Department of Anaesthesiology, University Medical Center Hamburg, Hamburg, Germany.
Curr Opin Anaesthesiol. 2020 Feb;33(1):101-108. doi: 10.1097/ACO.0000000000000812.
Alterations in cognitive functions are common in the perioperative course. Although often unnoticed by physicians, these alterations might have distinct long-term consequences for the patient with regard to everyday functioning, self-dependency, and quality of life. In recent years, however, perioperative cognition has gained increased interest, both by clinicians and scientists, and knowledge of the preventive measures of postoperative cognitive decline has become mandatory for anesthetists and surgeons.
This review offers a brief overview of the current state of knowledge concerning perioperative changes in cognition, including its pathophysiology and prevention strategies.
Postoperative neurocognitive disorders are frequent complications, especially in elderly patients, with postoperative delirium being its most pronounced and acute postoperative form, predisposing the patient for long-term cognitive impairment. The incidence of postoperative cognitive decline can be reduced by implementing preventive measures during perioperative patient care as recommended by national and international guidelines.
认知功能的改变在围手术期很常见。尽管这些改变常常被医生忽视,但它们可能会对患者的日常生活功能、自理能力和生活质量产生明显的长期影响。然而,近年来,围手术期认知功能已引起临床医生和科学家的广泛关注,麻醉师和外科医生必须了解预防术后认知功能下降的措施。
本综述简要概述了目前关于认知功能在围手术期变化的知识状态,包括其病理生理学和预防策略。
术后神经认知障碍是常见的并发症,尤其是在老年患者中,术后谵妄是其最明显和急性的术后形式,使患者容易发生长期认知障碍。通过在围手术期患者护理中实施国家和国际指南推荐的预防措施,可以降低术后认知功能下降的发生率。