Effects of Midazolam and Dexmedetomidine on Cognitive Dysfunction Following Open‐Heart Surgery: A Comprehensive Review

ABSTRACT Purpose Patients undergoing open‐heart surgery often face significant challenges in postoperative cognitive dysfunction (POCD). There has been growing interest in understanding how anesthesia medications, such as dexmedetomidine (DEX) and midazolam, impact cognitive function in these patients. Method This comprehensive review aims to detail the effect of DEX and midazolam on cognitive outcomes following open‐heart surgery. Findings Midazolam, a highly selective and commonly used benzodiazepine for preoperative anxiolytics and sedation has been associated with POCD. However, evidence regarding its impact on cognitive function is vague; some studies suggest a potential link between midazolam administration and cognitive impairment, while others report no effect or even an improvement in cognitive abilities. DEX is a potential neuroprotective agent in cardiac surgery. The effects of DEX on cognitive function, including a reduction in POCD incidence and severity, have been reported in several studies. It modulates the inflammatory responses, attenuates oxidative stress, and preserves cerebral perfusion. Although DEX and midazolam show promising results, their effects on cognitive function following open‐heart surgery are yet to be elucidated. Conclusion Various factors, including patient characteristics, perioperative management, and surgical procedures, may influence these outcomes, highlighting the need for further research to better understand the roles of these agents in cognitive function following open‐heart surgery.