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Dual roles of anesthetics in postoperative cognitive dysfunction: Regulation of microglial activation through

Mengxue Zhang1,2,3, Yiqing Yin1,2,3

  • 1Department of Anesthesiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.

Frontiers in Immunology
|February 13, 2023
PubMed

Insights

Anesthetics may worsen or improve postoperative cognitive dysfunction (POCD) by affecting brain inflammation. Careful anesthetic selection based on dose, duration, and patient factors is crucial for minimizing POCD risk.

Area of Science:

  • Neuroscience
  • Anesthesiology
  • Immunology

Background:

  • Postoperative cognitive dysfunction (POCD) is a common complication after surgery, characterized by neurocognitive decline.
  • Microglia-mediated neuroinflammation is a key mechanism underlying POCD.
  • Anesthetics are implicated in POCD development, but their role is debated due to dual anti- and pro-inflammatory effects.

Purpose of the Study:

  • To review how anesthetics modulate microglial activation and neuroinflammation.
  • To explore the dual role of anesthetics in the pathogenesis of POCD.
  • To discuss strategies for minimizing POCD incidence through anesthetic selection.

Main Methods:

  • Literature review of anesthetic mechanisms on microglial activation.
  • Analysis of inflammatory signaling pathways affected by anesthetics.
  • Evaluation of factors influencing anesthetic effects on cognition.

Main Results:

  • Anesthetics exhibit both pro- and anti-inflammatory properties by regulating microglial activation.
  • Perioperative anesthetic administration can either alleviate or exacerbate POCD.
  • Anesthetics' beneficial cognitive effects depend on dose, exposure time, and patient characteristics.

Conclusions:

  • Anesthetics have a complex, dual role in POCD pathogenesis.
  • Optimizing anesthetic choice based on individual patient factors and drug properties is essential for mitigating POCD.
  • Further research into anesthetic-induced neuroinflammation can guide clinical practice.
Keywords:
anestheticsinflammatory signaling pathwaysmicroglianeuroinflammationpostoperative cognitive dysfunction

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