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Review Article
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DOI: https://doi.org/10.4097/kja.23952
- Postoperative neurocognitive disorders in ambulatory surgery: a narrative review
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Junyong In1, Brian Chen2, Hansu Bae1, Sakura Kinjo3
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1Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
2Rosalind Franklin University Chicago Medical School, North Chicago, United States of America
3Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, United States of America
- Corresponding author: Sakura Kinjo ,Tel: 1-415-514-4346, Fax: 1-415-514-4346, Email: Sakura.Kinjo@ucsf.edu
- Received: December 27, 2023; Revised: April 2, 2024 Accepted: April 2, 2024.
- Abstract
- Postoperative neurocognitive disorders (PoNCDs), such as postoperative delirium and cognitive dysfunction or decline can occur after surgery, especially in older patients. This significantly affects patient morbidity and surgical outcomes. Among various risk factors, recent studies have shown that preoperative frailty is associated with developing these conditions. Although the mechanisms underlying PoNCDs remain unclear, neuroinflammation appears to play an important role in their development. For the prevention and treatment of PoNCDs, medication modification, a balanced diet, and prehabilitation and rehabilitation programs have been suggested. The risk of developing PoNCDs is thought to be lower in ambulatory patients. However, owing to technological advancements, an increasing number of older and sicker patients are undergoing more complex surgeries and are often not closely monitored after discharge. Therefore, equal attention should be paid to all patient populations. This article presents an overview of PoNCDs and highlights issues of particular interest for ambulatory surgery.
Keywords :Ambulatory surgery; Cognitive dysfunction; Delirium; Outpatient; Perioperative neurocognitive disorders; Postoperative complications
