The persistent effects of anaesthesia on the brain

Question 1

Anaesthesia-induced neurotoxicity in the
developing nervous system

Answer 1

All anaesthetic agents have been shown to cause apoptosis of neuronal cells. There is currently no clear evidence that this affects the developing child.

Current advice is to only operate when necessary in the under 3-year-old population and minimise time under anaesthetic and multiple anaesthetics as there is likely to be a dose-response relationship.

Question 2

Incidence of perioperative neurocognitive disorders and persistent cognitive decline in patients over 65 years having surgery

Answer 2

perioperative neurocognitive disorders 65%
persistent cognitive decline 10%

Question 3

RFx for perioperative neurocognitive disorders

Answer 3

• Advanced age
• Reduced educational status
• Pre-op cognitive dysfunction
• Sensory impairment
• Alcoholism
• Increased length of anaesthesia
• Respiratory complications
• Post-operative infection