Tabari Masoomeh, Moradi Ali, Rezaieh Golbon Asalforoush, Aghasizadeh Malihe
Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Brain Behav. 2025 Apr;15(4):e70421. doi: 10.1002/brb3.70421.
Patients undergoing open-heart surgery often face significant challenges in postoperative cognitive dysfunction (POCD). There has been growing interest in understanding how anesthesia medications, such as dexmedetomidine (DEX) and midazolam, impact cognitive function in these patients.
This comprehensive review aims to detail the effect of DEX and midazolam on cognitive outcomes following open-heart surgery.
Midazolam, a highly selective and commonly used benzodiazepine for preoperative anxiolytics and sedation has been associated with POCD. However, evidence regarding its impact on cognitive function is vague; some studies suggest a potential link between midazolam administration and cognitive impairment, while others report no effect or even an improvement in cognitive abilities. DEX is a potential neuroprotective agent in cardiac surgery. The effects of DEX on cognitive function, including a reduction in POCD incidence and severity, have been reported in several studies. It modulates the inflammatory responses, attenuates oxidative stress, and preserves cerebral perfusion. Although DEX and midazolam show promising results, their effects on cognitive function following open-heart surgery are yet to be elucidated.
Various factors, including patient characteristics, perioperative management, and surgical procedures, may influence these outcomes, highlighting the need for further research to better understand the roles of these agents in cognitive function following open-heart surgery.
接受心脏直视手术的患者在术后认知功能障碍（POCD）方面常常面临重大挑战。人们越来越关注了解麻醉药物，如右美托咪定（DEX）和咪达唑仑，对这些患者认知功能的影响。
本综述旨在详细阐述DEX和咪达唑仑对心脏直视手术后认知结果的影响。
咪达唑仑是一种高度选择性且常用于术前抗焦虑和镇静的苯二氮䓬类药物，与POCD有关。然而，关于其对认知功能影响的证据尚不明确；一些研究表明使用咪达唑仑与认知障碍之间可能存在联系，而其他研究则报告无影响甚至认知能力有所改善。DEX是心脏手术中一种潜在的神经保护剂。多项研究报道了DEX对认知功能的影响，包括降低POCD的发生率和严重程度。它可调节炎症反应、减轻氧化应激并维持脑灌注。尽管DEX和咪达唑仑显示出有前景的结果，但它们对心脏直视手术后认知功能的影响仍有待阐明。
包括患者特征、围手术期管理和手术操作在内的多种因素可能会影响这些结果，这突出表明需要进一步研究以更好地了解这些药物在心脏直视手术后认知功能中的作用。
