POSTOPERATIVE COGNITIVE DYSFUNCTION AFTER REGIONAL ANESTHESIA IN OLDER ADULTS: A SYSTEMATIC REVIEW OF INCIDENCE

Ngo Hoang Ngoc Mai1, Bui Dinh Hoan1, Nguyen Thi Hong Uyen1
1 University of Medicine and Pharmacy at Ho Chi Minh City

Main Article Content

Abstract

Objectives: To systematically synthesize available evidence on the incidence of postoperative cognitive dysfunction (POCD) in older adults undergoing surgery under regional anesthesia.


Research and methods: A systematic review was conducted in accordance with the PRISMA. Relevant studies were identified through searches of PubMed/MEDLINE, HINARI, and Google Scholar. Eligible studies included patients aged 60 years or older who underwent surgery under spinal, epidural, regional, or neuraxial anesthesia.


Results: Ten studies met the inclusion criteria and were included in the analysis. The reported incidence of POCD after regional or spinal anesthesia ranged from 4.25% to 36.6%. Pooled analysis using a random-effects model showed an overall incidence of POCD within 7 days after surgery of 15% (95% confidence interval: 9%–24%), with substantial heterogeneity among studies.


Conclusion: Postoperative cognitive dysfunction remains a relatively common complication in elderly patients undergoing regional or spinal anesthesia, with an estimated incidence of approximately 15% in the early postoperative period.

Article Details

References

1. Evered L, Silbert B, Knopman DS, et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery—2021. Br J Anaesth. 2021;127(4):464-471. doi:10.1016/j.bja.2021.06.016
2. Evered L, Scott DA, Silbert B, et al. Postoperative cognitive dysfunction is independent of type of surgery and anaesthesia: findings from a large prospective cohort study. Anesth Analg. 2018;126(1):481-487. doi:10.1213/ANE.0000000000002234
3. Zhao Q, Li Y, et al. Postoperative cognitive dysfunction—Current research. Front Behav Neurosci. 2024;18:1354315. doi:10.3389/fnbeh.2024.1354315
4. Pongraweewan P, Sutcharitchan P, et al. Incidence of postoperative cognitive dysfunction in older patients after major elective surgery in Bangkok. Sci Rep. 2025;15:15961. doi:10.1038/s41598-025-15961-x
5. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg. 2021;88:105906. doi:10.1016/j.ijsu.2021.105906