Background: Total intravenous anesthesia (TIVA) has progressed thanks to the pharmacokinetic and pharmacodynamics of well-known intravenous medicines like propofol as well as newer, shorter-acting agents like remifentanil, as well as the advancements in pharmacokinetic models and infusion pump technology. TIVA is now simple, safe, and accurate thanks to depth of anesthesia monitors and target-controlled infusion (TCI) pumps. Common infusion pumps can also be used for TIVA, therefore it's not always necessary to have access to more advanced equipment. We aimed to provide an outline about effects of dexmedetomidine and fentanyl on post-operative cognitive functions.

Conclusion: The locus coeruleus in the brain stem, where the greatest number of α2 adrenoceptors are located, is where dexmedetomidine exerts its effects. In addition to originating noradrenergic routes from the medulla oblongata to the spinal cord, the locus coeruleus plays an essential role in coordinating waking and sleeping by controlling neurotransmitter release. Fentanyl has been studied for its effects on cognitive function and its potential influence on the occurrence of postoperative cognitive dysfunction. However, it's important to note that the available evidence is limited, and the specific impact of fentanyl on cognitive function and POCD is still an area of ongoing research