4 ms·
IIRC there are still post-operative cognitive problems in major surgeries done without general anesthesia, suggesting that there's something else going on too.
by spekcular 4y ago
IIRC there are still post-operative cognitive problems in major surgeries done without general anesthesia, suggesting that there's something else going on too. (I don't doubt that anesthesia plays some role, though.)
edit: Found the reference: https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00752/full https://www.frontiersin.org/articles/10.3389/fpsyt.2018.0075....
"More convincingly, a recent study demonstrated that open abdominal surgery under local anesthesia caused increases in hippocampal IL-6, TNFα, and memory impairments (71), suggesting that anesthesia per se is not necessary for the production of neuroinflammation and subsequent development of POCD."
"As seen in observational studies, a prospective randomized clinical trial comparing the use of general vs. spinal anesthesia in extracorporeal shock wave lithotripsy showed no significant difference in the incidence of POCD defined by a neurocognitive battery (142), suggesting that surgery and not anesthesia causes POCD."
- pmoriarty 4y agoBut according to those quotes there was still anesthesia administered in all cases, just not always general anesthesia. So the possibility of anesthesia being the cause has not been ruled out by the studies you quote.
- spekcular 4y agoYou're right, of course. It's just much less clear to me why local anesthesia would be implicated in cognitive impairment. But the brain is a complex thing, so I suppose my intuitions don't count for much!
- rapjr9 4y agoDon't forget that most surgery also involves antibiotics which can be another cause of trauma, particularly to the microbiome. Changes to the microbiome have been shown to have cognitive effects recently.