The effect of postoperative anesthesia on cognitive impairment in patients

The study of the problem of postoperative cognitive impairment arose from the first moment of anesthesia usage. Over the long history of observations, enough clinical information has been accumulated, however, sometimes it is contradictory and difficult to understand. In most cases, the connection between the fact of surgical intervention with the use of anesthesia and a slowdown in neurocognitive recovery in patients has been confi rmed. There is still an ongoing debate about whether the effects on cognitive abilities can be explained either by the anesthetics themselves or by other factors. The aim of the work is to use a narrative review to study modern ideas about the effect of anesthesia on the occurrence of cognitive impairment and the further development of cognitive dysfunctions. Material and methods. To analyze the literature, sources from the international databases Web of Science, Scopus, PubMed, as well as the national library system eLibrary were used. Results and discussion. The review made it possible to collect the results of long-term clinical observations, as well as experimental studies. Several hypotheses have been put forward about the potential mechanisms triggering the occurrence and development of postoperative cognitive disorders, commonly referred to as postoperative cognitive dysfunction. In particular, special attention was paid to changes in the content of Aß- and Tau-protein substances, increased immunological markers of inflammation, impaired regulation of calcium, and mitochondrial dysfunction. All these mechanisms cannot be considered separately. It represents a complex of interrelated, consistent phenomena. Due to the increasing prevalence of various forms of dementia among the population, there is a need to solve the problem of a deeper study of potential factors affecting postoperative cognitive impairment. Conclusions. Contemporary researchers are faced with the task of further studying the risk factors of postoperative cognitive impairment, their systematization, development and implementation in clinical practice. New methods of anesthesia in surgical interventions involve the modernization of techniques that reduce the potential risk of cognitive dysfunction.