Wu Huimin, Ahammed Yaseen, Tian Shouyuan, Liu Yi, Sanders Robert D, Ma Daqing
From the Department of Anesthesiology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi Province, China.
Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Anesth Analg. 2025 Feb 19. doi: 10.1213/ANE.0000000000007404.
Postoperative neurocognitive disorders (PNDs) are frequent and serious perioperative complications in the elderly, and are associated with increased morbidity and mortality, length of hospital stay, and need for long-term care. At present, the pathogenesis of PND is not completely clear, and there are various risk factors including surgical trauma and stress mediating systemic inflammation towards neuroinflammation development which causes brain structural and functional changes namely PND. For elderly patients, perioperative neurological monitoring may provide insights into brain function status. Monitoring may also help clinicians identify potential risks which would ultimately allow timely and effective intervention for better perioperative safety and prognosis for elderly patients. In this review, we summarize the risk factors and potential mechanisms of PND, and discuss preliminary evidence regarding application of electroencephalography, functional near-infrared spectroscopy, functional magnetic resonance, and positron emission tomography imaging in monitoring the central nervous system during the postoperative period.
术后神经认知障碍（PNDs）是老年人常见且严重的围手术期并发症，与发病率和死亡率增加、住院时间延长以及长期护理需求相关。目前，PND的发病机制尚不完全清楚，存在多种危险因素，包括手术创伤和应激介导全身炎症向神经炎症发展，进而导致脑结构和功能改变，即PND。对于老年患者，围手术期神经监测可提供有关脑功能状态的见解。监测还可帮助临床医生识别潜在风险，这最终将使他们能够及时进行有效干预，以提高老年患者围手术期的安全性和预后。在本综述中，我们总结了PND的危险因素和潜在机制，并讨论了关于脑电图、功能近红外光谱、功能磁共振成像和正电子发射断层扫描成像在术后监测中枢神经系统应用的初步证据。
