Postoperative cognitive dysfunction (POCD) is a common complication of the surgical experience and is common in the elderly and patients with preexisting neurocognitive disorders. Animal and human studies suggest that neuroinflammation from either surgery or anesthesia is a major contributor to the development of POCD.
Typically, POCD is a transient disorder lasting up to three months. But there are questions about whether a small subset of patients may experience persistent irreversible cognitive decline. For the present, the subject of persistent cognitive decline remains highly controversial.
Post-operative cognitive dysfunction (POCD) is a state in which a patient’s memory and learning decline after surgery. POCD is common: 1 in 3 patients will have POCD at discharge. 1 in 10 patients will have POCD that lasts up to three months after surgery.
The postoperative delirium is mainly characterized by changes in the consciousness and cognition which are observed for a short period after surgery. Cognitive disorders include disorientation in space and time, language difficulties, impairment in learning and memory.
POCD is usually transient. It is diagnosed by comparing pre- and postoperative findings on psychometric tests. Its pathogenesis is multifactorial, with the immune response to surgery probably acting as a trigger.
Since the 1950’s, advanced age has been shown to be one of the strongest associations for development of POCD: the incidence of POCD is reported to be anywhere between 9 and 54% 1 week after surgery in adults over age 65 (6), with no difference in rates based on the type of surgery and/or anesthetic (7).
POCD is not some untreatable separate diagnosis that requires some strange outlying treatment approach. The most effective treatment for obsessive compulsive disorder is cognitive behavioral therapy (CBT).
Studies in people They found that general anaesthesia was associated with higher risks of dementia. The older the person when they had surgery the more likely they were to have a higher risk of dementia. The researchers suggested that older brains could be less resistant to damage caused by anaesthesia.
The risk of dementia increased in patients who received intravenous or intramuscular anaesthesia, regional anaesthesia and general anaesthesia. The results of our nationwide, population-based study suggest that patients who undergo anaesthesia and surgery may be at increased risk of dementia.
Blood flow to brain tissue may be reduced by a partial blockage or completely blocked by a blood clot. Symptoms of vascular dementia may develop gradually, or may become apparent after a stroke or major surgery, such as heart bypass surgery or abdominal surgery.
Results showed that 53 percent of patients experienced significant cognitive declines shortly after surgery. Six weeks later, 36 percent were impaired, and after six months, 24 percent. Five years after surgery, however, the incidence of cognitive decline had risen again, to 42 percent.
Conclusions: Lack of retention of material acquired into long-term memory during propofol administration, associated with minimal sedation, seems to define drug-induced amnesia. Sedation seems to impair the acquisition or encoding of material into long-term memory.
It may be that in some cases the trauma of undergoing surgery can expose pre-existing cognitive deterioration. For older people who experience post-operative delirium, studies have shown that they have an increased risk of developing dementia in the following years.
What does that mean for POCD sufferers? It means that ultimately there is no way to definitively prove that people with POCD are not in denial about being pedophiles. This means that the only sensible strategy for those with POCD is to accept that the certainty they seek is just not possible.
The differential diagnosis of POD includes dementia, emergence delirium, and postoperative cognitive dysfunction (POCD).
Postoperative delirium – This is a temporary condition that causes the patient to be confused, disoriented, unaware of their surroundings, and have problems with memory and paying attention. It may not start until a few days after surgery, comes and goes, and usually disappears after about a week.