The Impact of Anesthetic Agents on Postoperative Cognitive Function

Abstract

Postoperative cognitive dysfunction (POCD) is a recognized complication that has been observed across various surgical specialties, particularly among elderly patients and those with pre-existing neurological vulnerabilities. This paper presents an in-depth review of how anesthetic agents influence postoperative cognitive outcomes, integrating findings from clinical trials, meta-analyses, and basic science research. Mechanisms such as neuroinflammation, oxidative stress, and amyloid-beta deposition are explored. Special attention is given to comparing the cognitive effects of inhalational agents (sevoflurane, desflurane, isoflurane) with intravenous agents (propofol, dexmedetomidine, ketamine). Patient-specific factors such as age, comorbidities, and genetic predisposition are also considered. Strategies to mitigate POCD, including anesthesia depth monitoring, multimodal analgesia, and enhanced recovery protocols, are reviewed with practical recommendations.