Anesthesia and cognitive disorders: a systematic review of the clinical evidence

Abstract

Preclinical and clinical evidence suggest an association between anesthesia and cognitive disorders ranging from postoperative chronic dysfunction to Alzheimer's disease. Recent clinical insights are summarized in this paper. Areas covered: This systematic review was conducted and written in accordance with the preferred reporting items for systematic reviews and meta-analyses statement and was registered in the International Prospective Register of Systematic Review database. A literature search of PubMed, EMBASE and SCOPUS was accomplished according to a written protocol that included: clinical trials on humans, articles in English, papers published between April 2010 and February 2016 and complete studies. Expert commentary: There is a growing interest in establishing the possible relationship between anesthesia and the onset and progression of cognitive disorders. Further studies are required to determine the methods of monitoring anesthesia in older adults with dementia undergoing surgical procedures.

Lasting effects of general anesthetics on the brain in the young and elderly: “mixed picture” of neurotoxicity, neuroprotection and cognitive impairment

“…Despite the debatable cause of POCD syndromes, it remains a perioperative priority that demands all plausible factors to be considered for lowering its incidence. Amongst the many predisposing factors, the choice of anesthetic agent/technique represents a likely one [ 83 , 84 ].…”

Isoflurane anesthesia in aged mice and effects of A1 adenosine receptors on cognitive impairment

“…Furthermore, AD patients are more susceptible to development of cognitive function decline after anesthesia and surgery . Repeated exposure to general anesthetics, such as isoflurane, is a potential risk factor for development of POCD and AD . Furthermore, high level of Aβ in aging brain following general anesthetic exposure is likely to increase the risk of the POCD development .…”

Dexmedetomidine attenuates the toxicity of β‑amyloid on neurons and astrocytes by increasing BDNF production under the regulation of HDAC2 and HDAC5

“…The traditional anesthesia (e.g., isoflurane-mediated anesthesia) increases the risk of AD (15)(16)(17). Some traditional anesthetic agents are associated with AD pathogenesis (18). Behavioral tests in rodent models showed that a transient exposure to anesthetic drug isoflurane caused a lasting impairment to the cognition (15,16,19).…”