The integrative role of neuroinflammation, cerebral hypoperfusion, and anesthetic stress in the pathogenesis of postoperative cognitive dysfunction

Postoperative neurocognitive disorders (POND) are one of the most common and clinically significant complications in the postoperative period, associated with prolonged hospitalization, decreased quality of life, and an increased risk of longterm cognitive impairment, especially among elderly patients. The current scientific paradigm rejects the simplistic notion of POND as a direct and exclusive consequence of the pharmacological effects of general anesthetics on the brain. The aim of this review is to detail the pathophysiological components of POND, presenting them as sequential stages of a single pathogenetic process. PubMed, Google Scholar, and eLIBRARY.RU were used for this literature review. This review presents an analysis of the most substantiated integrative model for the pathogenesis of these disorders, according to which prolonged exposure to general anesthesia acts as a factor reducing the functional stability and adaptive reserve of the nervous system.

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