Post-Operative Cognitive Dysfunction: An exploration of the inflammatory hypothesis and novel therapies


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Abstract

HighlightsPost-operative cognitive dysfunction (POCD) is an established risk of surgery.The proposed feed-forward inflammatory process of POCD is well supported.Perioperative use of COX-II inhibitors and dexmedetomidine preserves cognition.Evidence for other agents is thin and heterogeneous.Post-Operative Cognitive Dysfunction (POCD) is a highly prevalent condition with significant clinical, social and financial impacts for patients and their communities. The underlying pathophysiology is becoming increasingly understood, with the role of neuroinflammation and oxidative stress secondary to surgery and anaesthesia strongly implicated. This review aims to describe the putative mechanisms by which surgery-induced inflammation produces cognitive sequelae, with a focus on identifying potential novel therapies based upon their ability to modify these pathways.

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