Key result
Whether major non-cardiac surgery or general anaesthesia increases the risk of long-term cognitive dysfunction in older people remains unclear due to methodological problems in existing research.
Why the study?
Does non-cardiac surgery or general anaesthesia increase the risk of long term cognitive dysfunction in older people?
Does non-cardiac surgery or general anaesthesia increase the risk of long term cognitive dysfunction in older people?
Current evidence is insufficient to conclude whether non-cardiac surgery causes long-term cognitive dysfunction in older patients, highlighting the need for better-designed studies with adequate control groups.
Outcomes from various studies differ, and no definite conclusion is possible Half of all people reaching the age of 65 subsequently have one or more operations,1 but despite substantial research on short term cognitive dysfunction within the first week after the operation little research has been undertaken into the potential long term effects on cognition. The exception is cardiac surgery, where cognitive dysfunction has been well documented and has usually been attributed to the adverse effects of cardiopulmonary bypass on the brain.2 3 Various risk factors for long term (defined as three months or more) postoperative cognitive dysfunction have been investigated, including type of anaesthetic agent, general versus regional anaesthesia, use of anticholinergic agents such as atropine, or the physiological effects of the anaesthetic such as hypoxia, hypotension, or hyper-ventilation. The multicentre International Study of Post-Operative Cognitive Dysfunction (ISPOCD1) compared 1218 patients aged 60 years and older undergoing major surgery with a control group (n = 321) of a similar age.4 At three months after …
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A 2004 study conducted an editorial in Postoperative cognitive dysfunction. Non-cardiac surgery vs. No surgery was evaluated. Whether major non-cardiac surgery or general anaesthesia increases the risk of long-term cognitive dysfunction in older people remains unclear due to methodological problems in existing research.
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