Gut Microbiota and Probiotics in Perioperative Management: A Narrative Review

Area of Science:

• Microbiology
• Neuroscience
• Gastroenterology

Background:

• The human gut hosts diverse microbes, forming a complex ecosystem.
• Emerging evidence suggests a connection between the gut microbiome and the brain (gut-brain axis).
• The gut microbiome can be modulated via prebiotics, probiotics, and synbiotics.

Purpose of the Study:

• To explore the clinical utility of modulating the gut microbiome in the perioperative period.
• To review the impact of gut microbiome alterations on perioperative anxiety and cognitive function.

Main Methods:

• A literature search was conducted across multiple databases (MEDLINE, Embase, Scopus, PubMed, Google Scholar).
• Included preclinical and clinical studies investigating gut microbiome alterations in animals and humans.
• Focused on perioperative factors like anxiolysis, probiotics/prebiotics, opioids, anesthetics, and stress.

Main Results:

• Gut microbiome alterations were associated with changes in preoperative anxiety.
• Postoperative delirium, cognitive dysfunction, and pain were significantly affected by gut microbiome modulation.
• Studies demonstrated effects of anxiolysis, probiotics/prebiotics, opioids, anesthetics, and perioperative stress on the gut microbiome.

Conclusions:

• Modulating the gut microbiome presents potential therapeutic strategies for the perioperative period.
• Further high-quality research is needed on the gut-brain axis, signaling pathways, and clinical applications.