Abstract：
Perioperative neurocognitive disorders (PND) are a cognitive impairment that occurs after anesthesia, especially in elderly patients and significantly affects their quality of life. The hippocampus, as a critical region for cognitive function and an important location in PND research, has recently attracted increasing attention. However, in the hippocampus the impact of anesthesia and its underlying mechanisms remain unclear. This review focuses on investigation of the effects of anesthesia on the hippocampal dopamine (DA) system and explores its potential association with PND. Through comprehensive review of existing studies, it was found that anesthesia affects the hippocampus through various pathways involved in metabolism, synaptic plasticity and oxygenation. Anesthesia may also influence the DA neurotransmitter system in the brain which plays a role in emotions, rewards, learning and memory functions. Specifically, anesthesia may participate in the pathogenesis of PND by affecting the DA system within the hippocampus. Future studies should explore the molecular mechanisms of these effects through techniques such as neuroimaging to study real-time effects to improve animal models to better simulate clinical observations. For clinical application, it is recommended that physicians exercise caution when selecting and managing anesthetic drugs by adopting comprehensive cognitive assessment methods to reduce post-anesthesia cognitive risk. Overall, this review provides a better understanding of the relationship between the hippocampal DA system and perioperative neurocognitive function and provides valuable guidance for prevention and treatment strategies for PND.
摘要：
围手术期神经认知障碍（PND）是麻醉后发生的认知障碍，尤其是老年患者，显著影响其生活质量。海马体,作为认知功能的关键区域和PND研究的重要位置，最近引起了越来越多的关注。然而,在海马中，麻醉的影响及其潜在机制尚不清楚。本文着重研究麻醉对海马多巴胺（DA）系统的影响，并探讨其与PND的潜在关联。通过对现有研究的全面回顾，发现麻醉通过参与代谢的各种途径影响海马，突触可塑性和氧合。麻醉还可能影响大脑中的DA神经递质系统，该系统在情绪中起作用，奖励,学习和记忆功能。具体来说,麻醉可能通过影响海马内DA系统参与PND的发病机制。未来的研究应该通过神经成像等技术探索这些效应的分子机制，以研究实时效应，以改善动物模型，从而更好地模拟临床观察。对于临床应用，建议医师在选择和管理麻醉药物时应谨慎,采用综合认知评估方法,以降低麻醉后认知风险.总的来说,本综述旨在更好地理解海马DA系统与围手术期神经认知功能之间的关系，并为PND的预防和治疗策略提供有价值的指导。
