Perioperative medicine & outcomes
Targeting glycolysis and maintaining glucose homeostasis for treating perioperative neurocognitive disorder: a narrative review
Authors' conclusion
Critically, perturbations in glycolytic-lactic acid dynamics impair synaptic plasticity, neuronal function, and glial responses, establishing a cycle that accelerates cognitive deterioration.
Study context
- Population
- Ageing surgical populations with perioperative neurocognitive disorder (PND)
Main finding
As reported in the abstract
- Aberrant glycolysis activation during anaesthesia/surgery triggers lactate accumulation, disrupts metabolic homeostasis, promotes neuroinflammation and oxidative stress
- IV anaesthetics (e.g. propofol) and inhalation anaesthetics (e.g. sevoflurane, isoflurane) differ in effects on metabolic pathways and correlation with PND
- Surgical trauma amplifies metabolic reprogramming, e.g. via neuroimmune activation
- Perturbed glycolytic-lactic acid dynamics impair synaptic plasticity, neuronal function and glial responses, creating a cycle accelerating cognitive deterioration
Original publication
Targeting glycolysis and maintaining glucose homeostasis for treating perioperative neurocognitive disorder: a narrative review. Br J Anaesth. Published 15 November 2025. doi:10.
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