title: Anaesthetics and analgesics; neurocognitive effects, organ protection and cancer reoccurrence an update.
abstract: Available general and local anaesthetics, third generation inhaled anaesthetics, propofol and amide class local anaesthetics are effective and reassuringly safe. They are all associated to low incidence of toxicology and or adverse-effects. There is however a debate whether anaesthetic drug and technique could exhibit effects beyond the primary effects; fully reversible depression of the central nervous system, dose dependent anaesthesia. Anaesthetics may be involved in the progression of neurocognitive side effects seen especially in the elderly after major surgery, so called Postoperative Cognitive Dysfunction. On the other hand anaesthetics may exhibit organ protective potential, reducing ischemia reperfusion injury and improving survival after cardiac surgery. Anaesthetics and anaesthetic technique may also have effects of cancer reoccurrence and risk for metastasis. The present paper provides an update around the evidence base around anaesthesia potential contributing effect on the occurrence of postoperative cognitive adverse-effects, organ protective properties and influence on cancer re-occurrence/metastasis.
authors: CapioLundbyHospital, Gothenburg, Sweden.
authors: I
authors: I
authors: Sellbrant
authors: Sahlgrenska University Hospital, Department of Anaesthesiology and Intensive Care, Unit of Day Surgery, Mölndal, Göteborg, Sweden.
authors: M
authors: M
authors: Brattwall
authors: The Sahlgrenska Academy, Institution of Health and Care Sciences, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: P
authors: P
authors: Jildenstål
authors: Institute of Health and Care Sciences, University of Gothenburg, The Sahlgrenska Academy, Gothenburg, Sweden.
authors: M
authors: M
authors: Warren-Stomberg
authors: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sweden; Department of Anaestesia, Norrtälje Hospital, TioHundra AB, Norrtälje, Sweden.
authors: S
authors: S
authors: Forsberg
authors: Institution for Clinical, Karolinska Institutet, Danderyds University Hospital, Stockholm, Sweden. Electronic address: Jan.Jakobsson@ki.se.
authors: J G
authors: JG
authors: Jakobsson
mesh_terms: D000700:Analgesics / Q000494:pharmacology*; D000758:Anesthesia / Q000009:adverse effects; D000777:Anesthetics / Q000494:pharmacology*; D003072:Cognition Disorders / Q000139:chemically induced*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011183:Postoperative Complications / Q000139:chemically induced; D020011:Protective Agents / Q000494:pharmacology; D015427:Reperfusion Injury / Q000517:prevention & control*
chemical_list: D000700:Analgesics; D000777:Anesthetics; D020011:Protective Agents
keywords: Anaesthetics; Cancer reoccurrence; Desflurane; General anaesthesia; Neurocognitive side effects; Organ protection; Postoperative cognitive dysfunction; Propofol; Sevoflurane