Back to Journals » Local and Regional Anesthesia » Volume 12

A clearer view on postoperative cognitive dysfunction? [Letter]

Authors van der Veen GJ, Slagt C

Received 17 January 2019

Accepted for publication 24 January 2019

Published 12 March 2019 Volume 2019:12 Pages 27—28

DOI https://doi.org/10.2147/LRA.S201896

Checked for plagiarism Yes

Editor who approved publication: Dr Stefan Wirz


Gijsbert J van der Veen, Cornelis Slagt
Department of Anaesthesia, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands

Fathy et al1 rightfully emphasize the importance of postoperative cognitive dysfunction (POCD) as it is associated with longer length of in-hospital stay and an increased mortality in the first year after surgery.2,3 However, in contrast to the conclusion made by Fathy et al, it is not anesthesia and surgery that are risk factors for the development of POCD.4 Baseline patient characteristics (education level, age, frailty) and in-hospital delirium are major contributors for the development of POCD.2–4 Subsequently there were no differences found in the incidence of POCD between regional vs general anesthesia.5 Although Fathy et al target a very vulnerable patient group with respect to risk factors of developing POCD, it is very unlikely, in relation to the aforementioned, that there will be a difference in incidence between two local anesthetics. Fathy et al confirm this in their own study;1 there is a similar (nonsignificant) incidence of POCD in patients receiving lidocaine and in patients receiving bupivacaine during cataract surgery. So, the challenge in the prevention of POCD is not in the anesthetic technique or drug, but in the identification and treatment of modifiable risk factors and postoperative delirium.

View the original paper by Fathy and colleagues

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]