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http://www.sciencemag.org/news/2017/05/will-surgery-sap-your-brain-power
Many of us can recount a similar story about a friend, colleague, or loved one—usually elderly—whose mental condition deteriorated after a visit to an operating room. "The comment that 'So-and-so has never been the same after the operation' is pervasive," says anesthesiologist Roderic Eckenhoff of the University of Pennsylvania.
Often, surgical patients are beset by postoperative delirium—delusions, confusion, and hallucinations—but that usually fades quickly. Other people develop what has been dubbed postoperative cognitive dysfunction (POCD), suffering problems with memory, attention, and concentration that can last months or even a lifetime. POCD not only disrupts patients' lives, but may also augur worse to come. According to a 2008 study, people who have POCD 3 months after they leave the hospital are nearly twice as likely to die within a year as are surgical patients who report no mental setbacks. With the ballooning senior population needing more surgeries, "this is going to become an epidemic," says anesthesiologist Mervyn Maze of the University of California, San Francisco.
What causes POCD, what makes some patients susceptible, and how best to protect their faculties are unclear. And some scientists still question whether surgery is to blame. Two prominent anesthesiologists called the idea that operations cause persistent mental declines a fallacy.
Yet more researchers and doctors are awakening to surgery's risks for the brain. Last year, the American Society of Anesthesiologists launched a Brain Health Initiative to spur research into the factors that make people vulnerable and to pinpoint preventive measures. Scientists now have a prime suspect for the cause of POCD: inflammation of the brain. And clinical trials are testing interventions that include drugs, changes in operating room procedures, and mental training. "I believe we are on the verge of some diagnostic and therapeutic advances," says Joseph Mathew, a cardiothoracic anesthesiologist at Duke University Medical Center in Durham, North Carolina.
(Score: 4, Informative) by kaszz on Thursday June 01 2017, @08:42PM
Particles resulting from the physical damage that cutting causes, affects the brain. Aside from that, the anesthetic have this effects:
* Desflurane
Side effects: Increased cerebral circulation that can result in increased cerebral pressure.
* Isoflurane
Side effects: The risk of neurodegeneration was increased in combination of these agents with nitrous oxide and benzodiazepines such as midazolam. Interact with three amino acid residues (G29, A30 and I31) of amyloid beta peptide and induce aggregation. This area is important as "some of the commonly used inhaled anesthetics may cause brain damage that accelerates the onset of Alzheimer’s disease. Side effects that can occur: Inflammation or damage on the liver. Serious muscle damage with symptom like unexplained muscle pain. Ileus.
* Nitrous oxide
Side effects: Not long term.
* Sevoflurane
Side effects: Raises intracranial pressure and can cause respiratory depression. Concern regarding the safety of anaesthesia is especially acute with regard to children and infants, where preclinical evidence from relevant animal models suggest that common clinically important agents, including sevoflurane, may be neurotoxic to the developing brain, and so cause neurobehavioural abnormalities in the long term
* Xenon
Side effects: None, is a neuroprotectant. (but expensive! 1999 price 10 EUR/liter)
More recently, several intravenous drugs have been developed which, if desired, allow inhaled general anesthetics to be avoided completely. (Miller, Ronald D (2010). Erikson, Lars I; Fleisher, Lee A; Wiener-Kronish, Jeanine P; Young, William L, eds. Miller's Anesthesia Seventh edition. USA: Churchill Livingstone Elsevier. ISBN 978-0-443-06959-8.)
One such non-inhaled anesthesia method is computer controlled infusion pump using Propofol developed in Glasgow, Scotland. Advantages is absence of a trigger for malignant hyperthermia. The method is not permitted in the United States. Pain on injection, especially in smaller veins which can be mitigated with Lidocaine.
So in all the conclusion is to look for inhaled Xenon if available and afforded. Or computer controlled infusion (TCI) using Propofol etc. I have the suspicion that all this is a dirty secret of the anesthesia industry.
Another note: Make sure that eyes are prevented from dryness and protected from mechanical damage.