Marques Ana Filipa Vieira da Silva Ferreira, Lapa Teresa Alexandra Santos Carvalho
Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.
Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal; Universidade da Beira Interior (CICS), Faculdade de Ciências da Saúde, Covilhã, Portugal.
Braz J Anesthesiol. 2018 Mar-Apr;68(2):174-182. doi: 10.1016/j.bjan.2017.09.003. Epub 2017 Nov 11.
It has been speculated that the use of anesthetic agents may be a risk factor for the development of Alzheimer disease. The objective of this review is to describe and discuss pre-clinical and clinical data related to anesthesia and this disease.
Alzheimer disease affects about 5% of the population over 65 years old, with age being the main risk factor and being associated with a high morbidity. Current evidence questions a possible association between anesthesia, surgery, and long-term cognitive effects, including Alzheimer disease. Although data from some animal studies suggest an association between anesthesia and neurotoxicity, this link remains inconclusive in humans. We performed a review of the literature in which we selected scientific articles in the PubMed database, published between 2005 and 2016 (one article from 1998 due to its historical relevance), in English, which address the possible relationship between anesthesia and Alzheimer disease. 49 articles were selected.
The possible relationship between anesthetic agents, cognitive dysfunction, and Alzheimer disease remains to be clarified. Prospective cohort studies or randomized clinical trials for a better understanding of this association will be required.
据推测，麻醉剂的使用可能是阿尔茨海默病发病的一个风险因素。本综述的目的是描述和讨论与麻醉及该疾病相关的临床前和临床数据。
阿尔茨海默病影响约5%的65岁以上人群，年龄是主要风险因素且与高发病率相关。目前的证据对麻醉、手术与包括阿尔茨海默病在内的长期认知影响之间可能存在的关联提出了质疑。尽管一些动物研究的数据表明麻醉与神经毒性之间存在关联，但在人类中这种联系仍无定论。我们对文献进行了综述，在PubMed数据库中选择了2005年至2016年发表的英文科学文章（由于其历史相关性，选入一篇1998年的文章），这些文章探讨了麻醉与阿尔茨海默病之间可能的关系。共选择了49篇文章。
麻醉剂、认知功能障碍与阿尔茨海默病之间的可能关系仍有待阐明。需要进行前瞻性队列研究或随机临床试验以更好地理解这种关联。
