Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
The Effect of Anesthesia on Postoperative Cognitive Dysfunction in Adults Undergoing Cataract Surgery: A Systematic Review Publisher Pubmed



Foroughi E1 ; Brogi E2 ; Forfori F3 ; Hashemi ST4
Authors
Show Affiliations
Authors Affiliations
  1. 1. Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Neuroscience Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
  3. 3. Department of Surgery, Universita di Pisa, Medical, Molecular, and Critical Area Pathology, Pisa, Italy
  4. 4. Department of Anaesthesia and Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran

Source: BMC Anesthesiology Published:2025


Abstract

Background: We systematically reviewed the evidence on the effect of anesthetic methods and drugs on the incidence of postoperative cognitive dysfunction (POCD) after cataract surgery. Methods: The Web of Science, PubMed, and Scopus databases were searched for relevant English reports published from 2000 to August 2024. After full-text screening and checking the quality assessment of each article using the JBI checklist, 9 relevant articles were included in this study. The included articles were reviewed to explain how different anesthetic modalities and drugs may affect the incidence of POCD after cataract surgery. Our study aimed to systematically investigate the relationship between various methods of anesthesia and POCD for people undergoing cataract surgery. Results: We included 9 clinical trials with 1014 participants, which analyzed the incidence of POCD after anesthetic interventions. Four articles compared the effect of anesthetic modality interventions on POCD and five studies compared the effect of anesthetic drugs on POCD. The studies used various cognitive measurement scales, including the Mini-Mental State Examination, Neurobehavioral Rating Scale, Blessed Orientation-Memory-Concentration Test, Iowa Satisfaction with Anesthesia scale, PALT, and VF test. All articles that compared local and topical anesthesia found no statistically significant difference in the incidence of cognitive dysfunction at postop days 1 and 7. General anesthesia may cause POCD approximately twofold than local anesthesia. Ketamine, Midazolam, or Dexmedetomidine seemed to reduce postoperative cognitive complications compared to the control group‌‌. Conclusions: This systematic review investigates how different anesthetic techniques and drugs may affect the incidence of POCD. The available literature is far from being conclusive and further studies are needed to reach any significant conclusions. It is necessary to adopt an appropriate anesthesia method for elderly and high-risk patients, especially people who have a history of cognitive problems‌‌ undergoing elective cataract surgery, to reduce cognitive complications after surgery.‌ © The Author(s) 2025.
Related Docs
View other Related Docs
1. A Comparison of the Effect of Intravenous Dexamethasone and Lidocaine on Prevention of Postoperative Cognitive Disorders in Cataract Surgery in Elderly Patients, Journal of Isfahan Medical School (2018)
2. The Effect of Intravenous Midazolam and Dexmedetomidine on Prevention of Cognitive Dysfunction After Cataract Surgery in the Elderly Patients Under General Anesthesia Compared With the Control Group, Journal of Isfahan Medical School (2019)
3. Prevention of Cognitive Dysfunction After Cataract Surgery With Intravenous Administration of Midazolam and Dexmedetomidine in Elderly Patients Undergoing Cataract Surgery, Advanced Biomedical Research (2019)
4. The Impact of General Anesthesia Vs Local Anesthesia With Intravenous Sedation on the Incidence of Postoperative Cognitive Dysfunction After Cataract Surgery in Elderly Patients, Journal of Isfahan Medical School (2016)
5. Comparison the Effects of Etomidate Infusion Versus Ketamine-Midazolam-Fentanyl Combination in Sedation for Cataract Surgery, Journal of Isfahan Medical School (2013)
6. Comparison Between the Effects of Acetaminophen, Dexmedetomidine, and Normal Saline Infusion on Pain Severity After Cataract Surgery, Advanced Biomedical Research (2022)
7. A Comparison of Sedative Effect of Dexmedetomidine-Fentanyl Versus Midazolam-Fentanyl During Cataract Surgery With Phacoemulsification Technique, Journal of Isfahan Medical School (2018)
8. Effects of Diclofenac Drops and Artificial Tear Drops on Pain Reduction After Cataract Surgery: A Comparative Study, Journal of Isfahan Medical School (2012)
Experts (# of related papers)
View all Related Experts
Hamidreza Shetabi (10)
Khosrou Naghibi (9)
Other Related Docs
9. Comparison Between the Effects of Propofol-Ketamine and Propofol-Fentanyl for Sedation in Cataract Surgery, Scientific Journal of Kurdistan University of Medical Sciences (2019)
10. Effects of Lidocaine on Reducing the Need for Anesthetic Drugs During Ophthalmologic Surgeries, Journal of Isfahan Medical School (2013)
11. Comparison of the Effect of Adding Ketamine to Sodium Thiopental and Propofol on the Quality of Sedation in Cataract Surgery With Phacoemulsification Under Local Anesthesia and Intravenous Sedation; [مقایسه‌ی اثر افزودن کتامین به سدیم تیوپنتال و پروپوفول بر کیفیت آرام‌بخشی در جراحی آب مروارید با فیکوامولسیفیکاسیون تحت بی‌حسی موضعی و آرام‌بخشی داخل وریدی], Journal of Isfahan Medical School (2024)
12. Comparative Study of Preemptive Ketorolac and Tetracaine Eye Drops on the Need for Sedatives and Analgesics During and After Cataract Surgery, Koomesh (2022)
13. Evaluation and Comparison of the Effects of Propofol, Dexamethasone, and Ondonestrone in the Prevention of Complications During and After Cataract Surgery, Journal of Isfahan Medical School (2018)
14. Evaluation of Efficacy and Results of Photorefractive Keratectomy on Hypermetropia of More Than +3.00 Diopter, 4 Months After Surgery, Journal of Isfahan Medical School (2009)
15. Comparing the Effects of Magnesium Sulfate and Nitroglycerin on the Control of Hypertension During and After Cataract Surgery Under Local Anesthesia and Intravenous Sedation, Journal of Isfahan Medical School (2016)
16. Prophylactic Versus Therapeutic Administration of Intravenous Lidocaine for Suppression of Post-Extubation Cough Following Cataract Surgery: A Randomized Double Blind Placebo Controlled Clinical Trial, Acta Anaesthesiologica Taiwanica (2005)
17. Effects of Age and Gender on Acute Postoperative Pain After Cataract Surgery Under Topical Anesthesia and Sedation, Journal of Isfahan Medical School (2017)
18. Comparison of the Effectiveness of Intranasal Ketamine Compared With Intravenous Ketamine in Controlling Pain During Cataract Surgery, Tehran University Medical Journal (2022)
19. Comparison of the Preventive Effect of Ketamine, Paracetamol and Metoclopramide on Postoperative Pain Intensity in General Anesthesia: A Double-Blind Clinical Trial, Scientific Journal of Kurdistan University of Medical Sciences (2019)
20. Comparing the Intraoperative Pain Severity in Phacoemulsification Cataract Surgery Under the Topical Anesthesia and Systemic Sedation in Patients With Hairy and Normal Eyebrow, Journal of Isfahan Medical School (2015)
21. Cotimparave Evaluation of Oral Alprazolam, As Premedication, on Controlling Blood Pressure in Hypertensive Patients During Surgery, Journal of Isfahan Medical School (2015)
22. Safety and Efficacy of Fentanyl Versus Pethidine in Cataract Surgery Under Propofol-Based Sedation: A Double-Blind Randomized Controlled Clinical Trial, Journal of Research in Medical Sciences (2020)
23. Evaluation of Cognitive Changes and Quality of Life in Patients With Refractory Frontal Lobe Epilepsy Before and After Surgery for the Treatment of Epilepsy, Journal of Isfahan Medical School (2021)
24. Evaluation of the Effect of Nasal Fentanyl in Comparison With Intravenous Fentanyl in Cataract Surgery by Phacoemulsification Method, Tehran University Medical Journal (2021)
25. The Effect of Intracameral Lidocaine Injection on Hemodynamic Parameters and Pain Intensity During and After Cataract Surgery Under Intravenous Sedation and Topical Anesthesia, Journal of Isfahan Medical School (2021)
26. The Comparison of the Efficacy and Safety of Sedation With Etomidate- Fentanyl Versus Ketamine-Midazolam Combinations in Cataract Surgery, Journal of Isfahan Medical School (2012)
27. The Frequency of Cognitive Impairment After Anesthesia in Patients Over 60 Years of Age, and Determination of Risk Factors, Journal of Isfahan Medical School (2018)
28. Comparison of Effects of Thiopental, Propofol or Ketamine on the Cardiovascular Responses of the Oculocardiac Reflex During Strabismus Surgery, Journal of Research in Medical Sciences (2007)
29. Comparative Study of Recovery Time and Complications After Anesthesia With Propofol in Mental Retarded and Healthy Patients, Journal of Isfahan Medical School (2011)
30. Tear Film in Myopic Patients With Moderate Dry Eye Before and After Photorefractive Keratectomy Surgery, Journal of Isfahan Medical School (2016)
31. Comparison of Sedation Quality and Pain With Propofol-Thiopental Sodium Versus Propofol-Etomidate in Cataract Surgery, Pakistan Journal of Ophthalmology (2024)
32. Effect of Dexmedetomidine Added to Lidocaine Cartridge on the Level of Patient Sedation, Cooperation, and Patient and Surgeon Satisfaction During Mandibular Third-Molar Extraction Surgery: A Randomized Double-Blind Controlled Trial, International Journal of Dentistry (2022)
33. Depth of Anesthesia Determination by Using Bispectral Index in Patients Underwent Inhalation or Total Intravenous General Anesthesia, Journal of Isfahan Medical School (2007)
34. Evaluation of Factors Affecting Post Cataract Surgery Headache, Journal of Isfahan Medical School (2016)
35. Comparing the Efficacy of Dimenhydrinate-Metoclopramide, Dimenhydrinate -Ondansetron and Dimenhydrinate Alone on Nausea and Vomiting After Cataract Surgery Under Local Anesthesia and Intravenous Sedation, Journal of Isfahan Medical School (2022)
36. Effects of Adding Subconjunctival Block to Intravenous Sedation and Topical Anesthesia for Phacoemulsification Surgery on Intraoperative Pain, Patient Cooperation, and Patient and Surgeon Satisfaction, Journal of Isfahan Medical School (2013)
37. The Effect of Ketorolac and Naphazoline-Antazoline Eye Drops on Ocular Complaints After Cataract Surgery, Tehran University Medical Journal (2022)
38. Sedation Quality of Low–Dose Ketamine Combined With Dexmedetomidine Versus Propofol in Phacoemulsification Under Local Anesthesia, Pakistan Journal of Ophthalmology (2023)
39. Impairment of Lacrimal Drainage After Cataract Surgery, Journal of Research in Medical Sciences (2007)
40. Influence of Pre-Emptive Versus Preventive Analgesia With Oral Acetaminophen on Postoperative Pain in Painful Ophthalmic Surgeries: Which One Is Better?, Journal of Research in Medical Sciences (2007)
41. Comparing the Quality of Topical Anesthesia With Warmed or Cold Tetracaine in Cataract Surgery, Journal of Isfahan Medical School (2013)
42. The Effects of an Interdisciplinary Supportive Educational Program on Anxiety Among Patients Undergoing Cataract Surgery, Nursing and Midwifery Studies (2021)
43. Comparing the Effect of Remifentanil, Propofol and Remifentanil Plus Propofol on the Sedation Score Among Patients Under Phacoemulsification Cataract Surgery, Journal of Isfahan Medical School (2016)
44. A Comparison of Intraocular Pressure and Hemodynamic Responses to Insertion of Laryngeal Mask Airway or Endotracheal Tube Using Anesthesia With Propofol and Remifentanil in Cataract Surgery, Journal of Research in Medical Sciences (2012)
45. Association of Patient Satisfaction With Cataract Grading in Five Types of Multifocal Iols, Advances in Therapy (2024)
46. The Effect of Preoperative Injection of Midazolam in the Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Ophthalmic Surgery Under General Anesthesia, Journal of Isfahan Medical School (2013)
47. Evaluation and Comparison of the Effect of Different Intraoperative Oxygen Concentrations on Reduction of Nausea and Vomiting After Laparoscopic Cholecystectomy Under General Anesthesia, Journal of Isfahan Medical School (2018)