Long term cognitive dysfunction in older people after non-cardiac surgery

摘要

Half of all people reaching the age of 65 subsequently have one or more operations, 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 cardiopul-monary bypass on the brain. 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.