Playing games with the brain: The possible link between anesthesia and Alzheimer's disease revisited

A Clinical Review of the Consequences of Anesthesia and Surgery in the Elderly Brain: "The Dark Side of the Moon"

“…A consensus statement from the First International Workshop on Anesthetics and Alzheimer's Disease initially shed some light on this possible link and provided some recommendations (53). A tailored anesthesia is needed for surgical patients of advanced age with underlying neurodegenerative disease: choosing total intravenous anesthesia, avoiding inhalational agents and benzodiazepines, monitoring the depth of anesthesia and if possible brain oxygenation, monitoring and controlling temperature and glycemia, and considering early extubation with a multimodal postoperative analgesic plan (23,54,55). In the only randomized study, Liu et al (41) evaluated whether exposure to anesthetics induces progression of mild cognitive impairment.…”

The Current Role of Total Intravenous Anesthesia in Cardiac Surgery: Total Intravenous Anesthesia and Cardiopulmonary Bypass

“…47 Based on experimental research, there is now a possible association between exposure to volatile anesthetic agents and the formation of neurofibrillary tangles and amyloid plaques in patients with Alzheimer disease. 48,49 In contrast, propofol has been shown to elicit direct neuroprotection by attenuating inflammatory responses during CPB, 24 by scavenging hydroxyl radicals formed by brain injury, 50 and by reducing the infarct size after experimental ischemiareperfusion (neuroapoptosis challenge) in the brain. 51…”