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View all comments by Sherrie St. James

Many studies have suggested that cognitive dysfunction may occur after anesthesia and surgery. However, opposite reports exist as well. In the recent retrospective cohort study, the authors have employed an approach of obtaining multiple assessments before the surgery or major illness and included participants with early Alzheimer disease. They have reported that there is no significant difference among surgery, major illness, or control groups in terms of the decline of cognitive function. However, they did find that the participants with dementia may decline more markedly than the participants without dementia.

These findings are important. But like all other retrospective studies, this study has several limitations, including the difficulty to find appropriate controls, as described in the manuscript. Therefore, the findings from this study and other post-operative cognitive dysfunction studies strongly suggest that there is a need to perform an adequately powered, multicenter human study to further define post-operative cognitive dysfunction.

View all comments by Zhongcong Xie

Your report was quite informative. While there still may be few conclusive studies to link AD to anesthesia, my personal suspicions of a related link still hold. My Mom at the age of 80, active, clear-minded, and driving, had denture repair at University at Buffalo School of Medicine by a student who for some reason choose to put my mother and another patient to sleep to fit dentures! She was so confused afterwards she couldn't remember how to get home. She said she's never been the same since, with mild confusion, and now at age 85, on meds for early-stage AD. One may default the cause to being age related, but in view of my personal knowledge of the her behavior and history, I beg to differ with the theory that there is no connection.

View all comments by Gerald Ramsey

The age-old question of general anesthesia such as clindamycin causing shock to the autonomic nervous system by blunting it is documented. The adjustment to unconsciousness and then consciousness can produce cognitive decline.

References:
Turck, F. B. (1903). SHOCK PRODUCED BY GENERAL ANESTHESIA WITH RELATION TO DISTURBANCES OF THE BLOOD AND GASTROINTESTINAL TRACT. JAMA, XL(18):1206-1212.

View all comments by Kiumars Lalezarzadeh