Negative effect of general anesthesia on the human brain - mechanism and methods of prevention

Abstract

Introduction andObjective. General anesthesia is an integral part of many medical procedures. Its main premise is that it is completely reversible and has no effect on the human brain. Unfortunately, a number of scientific findings report potential effects of anaesthetics on the human nervous system. The aim of this review is to present the negative impact of sevoflurane (inhalation anaesthetic) and propofol (intravenous anaesthetic) on the human brain with an analysis of its mechanisms and factors, and possible methods of preventing this phenomenon. Review Methods. A review was undertaken of the most current literature using PubMed and Google Scholar databases, on the mechanism of action and the negative effects of sevoflurane and propofol on the brain and methods of its prevention. Included are both original works, reviews and case reports from Poland and worldwide. Brief description of the state of knowledge. Post-operative cognitive dysfunction affects 10-65% of patients. Sevoflurane and propofol have potentially damaging effects on the human brain. This occurs mainly through induction of neuronal cell apoptosis and disruption of synaprogenesis by affecting receptor proteins, cell organelles (mitochondria, endoplasmic reituclum) and signaling pathways (apoptotic and trophic) of neurons. However, this effect depends on the drug dose and patient-dependent factors (age, diseases, cognitive status before anaesthesia). Summary. Anaesthetics have potentially harmful effects on the human brain, although only in large and repeated doses. One should also not forget the much more notable effect of mechanical damage to tissues during surgery. In order to prevent cognitive dysfunction, both a detailed preoperative assessment of the patient's condition and the use of additional pharmacological and non-pharmacological measures during surgery are important.