“Postoperative cognitive dysfunction (POCD) is a decline in cognitive function (especially in memory and executive functions) that may last from 1–12 months after surgery, or longer. In some cases, this disorder may persist for several years after major surgery. POCD is distinct from emergence delirium. Its causes are under investigation and occurs commonly in older patients and those with pre-existing cognitive impairment. The causes of POCD are not understood. It does not appear to be caused by lack of oxygen or impaired blood flow to the brain and is equally likely under regional and general anesthesia”
It's estimated that bout 40% of all persons over age 60 who are hospitalized for surgery have POCD on discharge, and about 10% have POCD three months later.
As a rule, the shorter the duration of action of the anesthetic agent, the shorter the duration of cognitive impairment in the immediate postoperative period. No definitive evidence has been found to date for the hypothesis that anesthesia itself causes prolonged POCD.
Source : Dtsch Arztebl Int. 2014 Feb; 111(8): 119–125.
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