Inhaled anesthesia and cognitive performance.
Despite technological advances in surgery and anesthesia during the last few decades, the incidence of postoperative cognitive dysfunction remains a relatively common complication in surgical patients. After surgery, elderly patients in particular often exhibit a transient reversible state of cerebral cognitive alterations. Anesthetics administered as part of a surgical procedure may alter the patient's behavioral state by influencing brain activity. This concise report will address the scientific evidence on the relationship between postoperative cognitive dysfunctions and the most common inhalational agents currently used in anesthesia (volatile anesthetics: isoflurane, desflurane and sevoflurane, gaseous nitrous oxide). The available literature does not allow definitive conclusions to be drawn on the possible differences between anesthetics in relation to the subsequent occurrence of cognitive dysfunction. However, such information is crucial to improve anesthesia performance and patient safety, as well as outcomes.
Mandal
Pravat K
PK
Neurospectroscopy and Neuroimaging Laboratory, National Brain Research Centre, Manesar, Gurgaon, India. pravat.mandal@gmail.com
Schifilliti
Daniela
D
Mafrica
Federica
F
Fodale
Vincenzo
V
D000367:Age Factors; D000368:Aged; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects*; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D000077335:Desflurane; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D008738:Methyl Ethers / Q000008:administration & dosage / Q000009:adverse effects; D009609:Nitrous Oxide / Q000008:administration & dosage / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; D009609:Nitrous Oxide