THE INFLUENCE OF NEUROPROTECTORS ON THE PATHOGENETIC MECHANISMS OF THE DEVELOPMENT OF COGNITIVE DISORDERS IN PATIENTS AFTER HIP JOINT REPLACEMENT UNDER SPINAL ANESTHESIA IN THE POSTOPERATIVE PERIOD

Abstract

The importance of medical and social significance of the problem of POСD is closely associated with the imperfection of means of prevention of its development, which to some extent is caused by the lack of clarity of risk factors and pathochemical mechanisms of the development of this complication. In general, a literature review of studies devoted to determining predictors of the occurrence of POCD demonstrated that there are many more questions than answers. It should be noted that our literature search did not reveal a single study on the effect of various drugs on postoperative cognitive function.Aim. To investigate the influence of neuroprotectors on the dynamics of indicators of vasculogenesis, synaptogenesis and synaptoplasticity, neurocytolysis and stress in the blood serum of patients undergoing hip arthroplasty under spinal anesthesia. Materials and methods. This study analyzed the dynamics of the following indicators: vascular endothelial growth factor (VEGF), neuron-specific enolase (NSE), brain-derived neurotrophic factor (BDNF) and the level of cortisol in the blood serum of patients against the background of the introduction of neuroprotectors such as: neurotropin, neurocytin and gliaton after hip arthroplasty joint under spinal anesthesia.The results. The use of neuroprotectors in patients undergoing hip arthroplasty under spinal anesthesia has been demonstrated. The analysis of the mechanisms of action of neuroprotectors on the activation of the stress-realizing hypothalamic-pituitary-adrenal system, the expression of neurocytolysis, vasculogenesis, synaptogenesis and synaptoplasty is presented.Conclusions. The neuroprotectors used in the examined patients stimulated the processes of angiogenesis, synaptogenesis and synaptoplasticity, prevented neurodestructive changes, and with varying effectiveness restrained the hyperactivation of the stress-releasing hypothalamic-pituitary-adrenal system in patients after hip arthroplasty (HIP), and their effectiveness depended on the selected drug.