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general anesthesia
Physiology:
Effects of general inhalation anesthesia & muscle paralysis:
1) reduced thoracic compliance
2) lower residual capacity
3) mismatching of ventilation/perfusion
Adverse effects:
- may precipitate paroxysm of pheochromocytoma [1]
- elective surgery with general anesthesia
- not associated with increased risk for dementia [3]
- associated with increase risk of cognitive impairment in elderly Chinese
- conversion from normal cognition to mild cognitive impairment (MCI)
- relative risk = 1.5; absolute risk = 8.2% [4]
- conversion to MCI correlates with diminished volume of the right amygdala
General
anesthesia
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, 16.
American College of Physicians, Philadelphia 1998, 2012
- Merry AF et al.
Multimodal system designed to reduce errors in recording and
administration of drugs in anaesthesia: Prospective
randomised clinical evaluation.
BMJ 2011 Sep 22; 343:d5543
PMID: 21940742
- Velkers C et al
Association Between Exposure to General Versus Regional Anesthesia
and Risk of Dementia in Older Adults.
J Am Geriatrics Soc, 2020 Oct 6.
PMID: 33025584
https://onlinelibrary.wiley.com/doi/10.1111/jgs.16834
- Li W, Jiang J, Zhang S et al
Prospective association of general anesthesia with risk of cognitive decline
in a Chinese elderly community population.
Sci Rep. 2023 Aug 18;13(1):13458
PMID: 37596302 PMCID: PMC10439205 Free PMC article
https://www.nature.com/articles/s41598-023-39300-5