Sun Jeffrey Y
NYU Langone Health, Department of Anesthesiology, Perioperative Care and Pain Medicine, New York, New York, USA.
J Anaesthesiol Clin Pharmacol. 2020 Jul-Sep;36(3):297-302. doi: 10.4103/joacp.JOACP_118_19. Epub 2020 Sep 14.
As early as 1955, it was Bedford who provided description of cognitive changes in elderly patients following anesthesia and surgery. Reports of individuals with catastrophic, non-stroke-related decline in cognitive functions following anesthesia and surgery lead to a perception in the lay population that anesthesia and surgery have the potential to greatly exaggerate the progression of dementia, particularly Alzheimer's disease (AD). There is a concern that anesthesia and surgery could cause irreversible impairment, leading to AD. This could also explain the accelerated decline in patients with mild cognitive impairment. We seek to explore the relevant literature to determine whether a correlation exists and then propose a possible pathophysiologic mechanism.
早在1955年,贝德福德就对老年患者麻醉和手术后的认知变化进行了描述。关于麻醉和手术后出现与中风无关的灾难性认知功能衰退个体的报告,使普通大众认为麻醉和手术有可能极大地加速痴呆症,尤其是阿尔茨海默病(AD)的进展。人们担心麻醉和手术可能导致不可逆转的损害,进而引发AD。这也可以解释轻度认知障碍患者认知能力加速衰退的现象。我们试图探究相关文献,以确定是否存在相关性,然后提出一种可能的病理生理机制。