Post-operative cognitive decline, or dysfunction (POCD), is a recognized clinical phenomenon in which patients experience lasting cognitive impairment for some time following anesthesia. Read more here: cognition health disease operation
References Post-operative cognitive decline, or dysfunction , is a recognized clinical phenomenon in which patients experience lasting cognitive impairment for some time following anesthesia.
How does POCD manifest? POCD has been recognized in patients following anesthetized surgery since the mid-19th century. The British Medical Journal published a paper titled “Insanity Following the Use of Anaesthetics in Operations” in 1887. Typically, tests involving connecting a series of numbered or alphabetized shapes in ascending order, memorizing and recalling a number series, or tests of manual dexterity such as the grooved pegboard test, are employed during clinical neuropsychological examination.
The same study found that patients that had experienced POCD had a higher risk of death within one year than those that had not, normalized by condition, and an 8.5-year follow-up study by Steinmetx et al. found higher average mortality under the same conditions of 1.63. A history of alcohol abuse, even with recent abstinence, a clinical history of depression, and a low educational level are each additional risk factors in the development of POCD, and cardiac surgery in particular is known to lead to a higher incidence of POCD amongst elderly patients.
Interestingly, local anesthetic may cause POCD at almost or equal incidence rate as general anesthesia, and no evidence of long-term anesthetic neurotoxicity has emerged from twin studies, thus it is not necessarily thought that anesthesia itself is the cause of POCD.
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