Does Dexmedetomidine Ameliorate Postoperative Cognitive Dysfunction? A Brief Review of the Recent Literature

Zyad Carr, Theodore Cios, Kenneth F. Potter, John Swick

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Purpose of Review: Postoperative cognitive dysfunction (POCD) occurs in 20–50% of postsurgical patients with a higher prevalence in elderly patients and patients with vascular disease and heart failure. In addition, POCD has been associated with many negative outcomes, such as increased hospital length of stay, increased rates of institutionalization, and higher patient mortality. This brief review discusses select evidence suggesting an association between neuroinflammation and POCD and whether the use of dexmedetomidine, a short-acting alpha 2 agonist, may ameliorate the incidence of POCD. We review the recent evidence for neuroinflammation in POCD, dexmedetomidine’s properties in reducing inflammatory-mediated brain injury, and clinical studies of dexmedetomidine and POCD. Recent Findings: There is evidence to support the anti-inflammatory and immunomodulatory effects of dexmedetomidine in animal models. Several clinical investigations have demonstrated favorable outcomes using dexmedetomidine over placebo for the reduction of postoperative delirium. Few studies have used high-quality endpoints for the assessment of POCD and no demonstrable evidence supports the use of dexmedetomidine for the prevention of POCD. Summary: While evidence exists for the neural anti-inflammatory properties of dexmedetomidine, human trials have yielded incomplete results concerning its use for the management of POCD. Dexmedetomidine may reduce acute postoperative delirium, but further studies are needed prior to recommending the use of dexmedetomidine for the direct reduction of POCD.

Original languageEnglish (US)
Article number64
JournalCurrent neurology and neuroscience reports
Volume18
Issue number10
DOIs
StatePublished - Oct 1 2018

Fingerprint

Dexmedetomidine
Delirium
Length of Stay
Anti-Inflammatory Agents
Cognitive Dysfunction
Institutionalization
Vascular Diseases
Brain Injuries
Animal Models
Heart Failure
Placebos

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Clinical Neurology

Cite this

@article{ea6583aab93e40cbad28c9293c88644e,
title = "Does Dexmedetomidine Ameliorate Postoperative Cognitive Dysfunction? A Brief Review of the Recent Literature",
abstract = "Purpose of Review: Postoperative cognitive dysfunction (POCD) occurs in 20–50{\%} of postsurgical patients with a higher prevalence in elderly patients and patients with vascular disease and heart failure. In addition, POCD has been associated with many negative outcomes, such as increased hospital length of stay, increased rates of institutionalization, and higher patient mortality. This brief review discusses select evidence suggesting an association between neuroinflammation and POCD and whether the use of dexmedetomidine, a short-acting alpha 2 agonist, may ameliorate the incidence of POCD. We review the recent evidence for neuroinflammation in POCD, dexmedetomidine’s properties in reducing inflammatory-mediated brain injury, and clinical studies of dexmedetomidine and POCD. Recent Findings: There is evidence to support the anti-inflammatory and immunomodulatory effects of dexmedetomidine in animal models. Several clinical investigations have demonstrated favorable outcomes using dexmedetomidine over placebo for the reduction of postoperative delirium. Few studies have used high-quality endpoints for the assessment of POCD and no demonstrable evidence supports the use of dexmedetomidine for the prevention of POCD. Summary: While evidence exists for the neural anti-inflammatory properties of dexmedetomidine, human trials have yielded incomplete results concerning its use for the management of POCD. Dexmedetomidine may reduce acute postoperative delirium, but further studies are needed prior to recommending the use of dexmedetomidine for the direct reduction of POCD.",
author = "Zyad Carr and Theodore Cios and Potter, {Kenneth F.} and John Swick",
year = "2018",
month = "10",
day = "1",
doi = "10.1007/s11910-018-0873-z",
language = "English (US)",
volume = "18",
journal = "Current Neurology and Neuroscience Reports",
issn = "1528-4042",
publisher = "Current Medicine Group",
number = "10",

}

Does Dexmedetomidine Ameliorate Postoperative Cognitive Dysfunction? A Brief Review of the Recent Literature. / Carr, Zyad; Cios, Theodore; Potter, Kenneth F.; Swick, John.

In: Current neurology and neuroscience reports, Vol. 18, No. 10, 64, 01.10.2018.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Does Dexmedetomidine Ameliorate Postoperative Cognitive Dysfunction? A Brief Review of the Recent Literature

AU - Carr, Zyad

AU - Cios, Theodore

AU - Potter, Kenneth F.

AU - Swick, John

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Purpose of Review: Postoperative cognitive dysfunction (POCD) occurs in 20–50% of postsurgical patients with a higher prevalence in elderly patients and patients with vascular disease and heart failure. In addition, POCD has been associated with many negative outcomes, such as increased hospital length of stay, increased rates of institutionalization, and higher patient mortality. This brief review discusses select evidence suggesting an association between neuroinflammation and POCD and whether the use of dexmedetomidine, a short-acting alpha 2 agonist, may ameliorate the incidence of POCD. We review the recent evidence for neuroinflammation in POCD, dexmedetomidine’s properties in reducing inflammatory-mediated brain injury, and clinical studies of dexmedetomidine and POCD. Recent Findings: There is evidence to support the anti-inflammatory and immunomodulatory effects of dexmedetomidine in animal models. Several clinical investigations have demonstrated favorable outcomes using dexmedetomidine over placebo for the reduction of postoperative delirium. Few studies have used high-quality endpoints for the assessment of POCD and no demonstrable evidence supports the use of dexmedetomidine for the prevention of POCD. Summary: While evidence exists for the neural anti-inflammatory properties of dexmedetomidine, human trials have yielded incomplete results concerning its use for the management of POCD. Dexmedetomidine may reduce acute postoperative delirium, but further studies are needed prior to recommending the use of dexmedetomidine for the direct reduction of POCD.

AB - Purpose of Review: Postoperative cognitive dysfunction (POCD) occurs in 20–50% of postsurgical patients with a higher prevalence in elderly patients and patients with vascular disease and heart failure. In addition, POCD has been associated with many negative outcomes, such as increased hospital length of stay, increased rates of institutionalization, and higher patient mortality. This brief review discusses select evidence suggesting an association between neuroinflammation and POCD and whether the use of dexmedetomidine, a short-acting alpha 2 agonist, may ameliorate the incidence of POCD. We review the recent evidence for neuroinflammation in POCD, dexmedetomidine’s properties in reducing inflammatory-mediated brain injury, and clinical studies of dexmedetomidine and POCD. Recent Findings: There is evidence to support the anti-inflammatory and immunomodulatory effects of dexmedetomidine in animal models. Several clinical investigations have demonstrated favorable outcomes using dexmedetomidine over placebo for the reduction of postoperative delirium. Few studies have used high-quality endpoints for the assessment of POCD and no demonstrable evidence supports the use of dexmedetomidine for the prevention of POCD. Summary: While evidence exists for the neural anti-inflammatory properties of dexmedetomidine, human trials have yielded incomplete results concerning its use for the management of POCD. Dexmedetomidine may reduce acute postoperative delirium, but further studies are needed prior to recommending the use of dexmedetomidine for the direct reduction of POCD.

UR - http://www.scopus.com/inward/record.url?scp=85051226229&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85051226229&partnerID=8YFLogxK

U2 - 10.1007/s11910-018-0873-z

DO - 10.1007/s11910-018-0873-z

M3 - Review article

C2 - 30083844

AN - SCOPUS:85051226229

VL - 18

JO - Current Neurology and Neuroscience Reports

JF - Current Neurology and Neuroscience Reports

SN - 1528-4042

IS - 10

M1 - 64

ER -