Thaler Adam, Siry Read, Cai Lufan, García Paul S, Chen Linda, Liu Renyu
Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, USA.
J Anesth Clin Res. 2012 Feb 20;3(2). doi: 10.4172/2155-6148.1000192.
The long-term cognitive effects of general anesthesia are under intense scrutiny. Here we present 5 cases from 2 academic institutions to analyze some common features where the patient's or the patient family member has made a request to address their concern on memory loss, Alzheimer's disease and general anesthesia before surgery.
Records of anesthesia consultation separate from standard preoperative evaluation were retrieved to identify consultations related to memory loss and Alzheimer's disease from the patient and/or patient family members. The identified cases were extensively reviewed for features in common. We used Google® (http://www. google.com/) to identify available online information using "anesthesia memory loss" as a search phrase.
Five cases were collected as a specific preoperative consultation related to memory loss, Alzheimer's disease and general anesthesia from two institutions. All of the individuals either had perceived memory impairment after a prior surgical procedure with general anesthesia or had a family member with Alzheimer's disease. They all accessed public media sources to find articles related to anesthesia and memory loss. On May 2, 2011, searching "anesthesia memory loss" in Google yielded 764,000 hits. Only 3 of the 50 Google top hits were from peer-reviewed journals. Some of the lay media postings made a causal association between general anesthesia and memory loss and/or Alzheimer's disease without conclusive scientific literature support.
The potential link between memory loss and Alzheimer's disease with general anesthesia is an important preoperative concern from patients and their family members. This concern arises from individuals who have had history of cognitive impairment or have had a family member with Alzheimer disease and have tried to obtain information from public media. Proper preoperative consultation with the awareness of the lay literature can be useful in reducing patient and patient family member's preoperative anxiety related to this concern.
全身麻醉对认知的长期影响正受到密切关注。在此,我们展示来自2家学术机构的5个病例,以分析一些常见特征,这些病例中患者或患者家属在手术前就记忆力丧失、阿尔茨海默病和全身麻醉提出了相关诉求,希望解决他们的担忧。
检索与标准术前评估分开的麻醉会诊记录,以识别来自患者和/或患者家属的与记忆力丧失和阿尔茨海默病相关的会诊。对识别出的病例进行全面审查以寻找共同特征。我们使用谷歌(http://www.google.com/),以“麻醉记忆力丧失”作为搜索词来识别可用的在线信息。
从两家机构收集了5个作为与记忆力丧失、阿尔茨海默病和全身麻醉相关的特定术前会诊病例。所有这些人要么在之前接受全身麻醉的手术过程后感觉有记忆障碍,要么有患阿尔茨海默病的家庭成员。他们都通过大众媒体来源查找与麻醉和记忆力丧失相关的文章。2011年5月2日,在谷歌中搜索“麻醉记忆力丧失”得到764,000条结果。谷歌搜索结果排名前50的命中项中只有3条来自同行评审期刊。一些大众媒体的帖子在没有确凿科学文献支持的情况下,将全身麻醉与记忆力丧失和/或阿尔茨海默病建立了因果联系。
记忆力丧失和阿尔茨海默病与全身麻醉之间的潜在联系是患者及其家属术前关注的重要问题。这种担忧源于有认知障碍病史或有患阿尔茨海默病家庭成员的个体,他们试图从大众媒体获取信息。在了解大众文献的情况下进行适当的术前会诊,有助于减轻患者及其家属因这一担忧而产生的术前焦虑。