Developmental disability in the young and postoperative cognitive dysfunction in the elderly after anesthesia and surgery: do data justify changing clinical practice?

Abstract

The assumption that anesthesia has no serious, long-term, adverse central nervous system consequences may be true for most patients between 6 months and 60 years of age. However, for patients younger than 6 months or older than 60 years, that status quo assumption is under challenge from a growing body of evidence. Fetuses and newborns appear to be at risk because systems that would enable them to fully recover from the effects of more than 2 hours of anesthesia are still in development. In distinction, the elderly appear to be at risk because systems that once enabled them to fully recover have ever-diminishing capacity. Even for those between the age of 6 months and 60 years, full recovery may require replacing apoptosed neurons and pruning overabundant dendritic spines…perhaps leaving patients not quite the same person that they were before they were anesthetized.

• Authors: James E Cottrell, John Hartung
• Journal: The Mount Sinai journal of medicine, New York (Mt Sinai J Med) 2012 Jan-Feb Vol. 79 Issue 1 Pg. 75-94 ISSN: 1931-7581 [Electronic] United States
• PMID: 22238041 (Publication Type: Journal Article, Review)
• Copyright: © 2012 Mount Sinai School of Medicine.

Topics

• Age Factors
• Anesthesia (adverse effects)
• Animals
• Cognition Disorders (epidemiology, etiology)
• Developmental Disabilities (epidemiology, etiology)
• Humans
• Incidence
• Postoperative Complications
• Surgical Procedures, Operative (adverse effects)
• Time Factors