The Journal of Practical Medicine ›› 2026, Vol. 42 ›› Issue (8): 1479-1484.doi: 10.3969/j.issn.1006-5725.2026.08.024

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Mechanisms and clinical application of dexmedetomidine in reducing postoperative delirium after liver surgery via neuroimmune modulation

Yihao JIANG,Heliang SUN,Yongliang CAI,Jianjun YANG,Zhongyun WANG()   

  1. Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210000,Jiangsu,China
  • Received:2025-12-18 Online:2026-04-25 Published:2026-04-28
  • Contact: Zhongyun WANG E-mail:zywang1970@126.com

Abstract:

Postoperative delirium (POD) exhibits a relatively high incidence among patients undergoing liver surgery, especially after liver transplantation. Risk factors, including preoperative hepatic insufficiency, intraoperative hepatic ischemia-reperfusion injury, and postoperative sleep deprivation, contribute to the occurrence of POD in liver surgery by influencing neuroimmunity. Dexmedetomidine (DEX) can directly disrupt neuroimmune circuits via its anti-inflammatory, anti-oxidant, and anti-apoptotic effects. Moreover, it can also optimize the neuroimmune microenvironment by enhancing the glymphatic system, enhancing sleep quality, and facilitating neuronal proliferation, ultimately decreasing the incidence of POD. This article intends to systematically review the mechanisms and clinical application of DEX in reducing the incidence of POD after liver surgery by modulating neuroimmunity through mitigating inflammatory responses and reinforcing neuroprotection.

Key words: postoperative delirium, dexmedetomidine, neuroimmunity, hepatic surgery, ischemia-reperfusion

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