Abstract：
For years, postoperative cognitive outcomes have steadily garnered attention, and in the past decade, they have remained at the forefront. This prominence is primarily due to empirical research emphasizing their potential to compromise patient autonomy, reduce quality of life, and extend hospital stays, and increase morbidity and mortality rates, especially impacting elderly patients. The underlying pathophysiological process might be attributed to surgical and anaesthesiological-induced stress, leading to subsequent neuroinflammation, neurotoxicity, burst suppression and the development of hypercoagulopathy. The beneficial impact of multi-faceted strategies designed to mitigate the surgical and perioperative stress response has been suggested. While certain potential risk factors are difficult to modify (e.g., invasiveness of surgery), others - including a more personalized depth of anaesthesia (EEG-guided), suitable analgesia, and haemodynamic stability - fall under the purview of anaesthesiologists. The ESAIC Safe Brain Initiative research group recommends implementing a bundle of non-invasive preventive measures as a standard for achieving more patient-centred care. Implementing multi-faceted preoperative, intraoperative, and postoperative preventive initiatives has demonstrated the potential to decrease the incidence and duration of postoperative delirium. This further validates the importance of a holistic, team-based approach in enhancing patients\' clinical and functional outcomes. This review aims to present evidence-based recommendations for preventing, diagnosing, and treating postoperative neurocognitive disorders with the Safe Brain Initiative approach.
摘要：
多年来,术后认知结果稳步受到关注，在过去的十年里，他们一直走在前列。这种突出主要是由于实证研究强调了它们损害患者自主性的潜力，降低生活质量，延长住院时间，增加发病率和死亡率，尤其是影响老年患者。潜在的病理生理过程可能归因于手术和麻醉学引起的压力，导致随后的神经炎症，神经毒性，爆发抑制和高凝血症的发展。已经提出了旨在减轻手术和围手术期应激反应的多方面策略的有益影响。虽然某些潜在的风险因素很难修改(例如，手术的侵入性)，其他-包括更个性化的麻醉深度（脑电图引导），合适的镇痛，和血液动力学稳定性-属于麻醉师的职权范围。ESAICSafeBrainInitiative研究小组建议实施一系列非侵入性预防措施，作为实现以患者为中心的护理的标准。实施多方面的术前，术中,和术后预防措施已证明有可能降低术后谵妄的发生率和持续时间.这进一步验证了整体的重要性，以团队为基础的方法提高患者的临床和功能结局。这篇综述旨在提出基于证据的预防建议，诊断,并使用安全大脑倡议方法治疗术后神经认知障碍。
