Electroacupuncture mitigates cognitive impairment caused by anesthesia and surgery in aged rats by inhibiting the p38 MAPK signaling pathway.

Electroacupuncture (EA) effectively enhances postoperative cognitive function in the elderly, though its underlying mechanism remains largely unexplored. This study aimed to explore the role of the p38 MAPK signaling pathway in how EA alleviates anesthesia/surgery-induced cognitive impairment in aged rats. We developed a POCD model using sevoflurane anesthesia and exploratory laparotomy in aged rats to evaluate whether EA at the Neiguan, Hegu and Zusanli points influences synaptic plasticity in the POCD pathological process. The Novel object recognition test assessed postoperative cognitive function. Nissl staining is used to evaluate the pathological changes of neurons. Changes in synaptic function and its potential mechanism were assessed using RNA-seq, Golgi-cox staining, Western blot and Immunofluorescence assay. The study found that anesthesia and surgery notably impaired cognitive performance and synaptic function in the hippocampal CA1 region of aged rats. EA improved cognitive function, restored hippocampal synaptic function, decreased the phosphorylated p38 and increase the PSD-95 and synaptophysin expression level in POCD rats. In conclusion, EA ameliorated POCD in aged rats, potentially by enhancing synaptic function via inhibition of the p38 MAPK signaling pathway.