Friday, March 25, 2016

Anesthesia After 40 Not Linked to Mental Decline Later

Mayo Clinic researchers followed more than 1,700 people in Minnesota, aged 70 to 89, who had normal mental function when the study began in 2004. About 85% of the participants had at least one surgery requiring general anesthesia after age 40. The study participants were evaluated every 15 months.

“The bottom line of our study is that we did not find an association between exposure to anesthesia for surgery and the development of mild cognitive [mental] impairment in these patients,” study senior author and anesthesiologist Dr. David Warner said in a Mayo news release.

Of the participants, 31% developed mild thinking and memory problems during the study period, but it was not associated with their anesthesia exposure, the researchers said.

The findings were published in the February issue of the journal Mayo Clinic Proceedings.

A previous Mayo study found that older patients who receive anesthesia do not have an increased risk of dementia.

The investigators behind the new study are also examining how general anesthesia affects young children and have noted some associations between childhood anesthesia and learning and memory problems later in life.

“That by no means is established yet. Right now it’s just associations, and we and many other people are doing a lot of work to try to see if this really is a problem in children or not,” Warner said in the news release.

“Because of the associations that we’ve seen, there is more concern in the young than the old, and it will require quite a bit more research to find out what is happening with the children, and if there is a problem, how we can best address it,” he added.

My Take:
The first scary statistic is that 85% of the participants had at least one surgery after the age of 40 requiring general anesthetic. That’s probably an accurate representation of the general population. I unfortunately, am one of that large majority. At the age of 57, I developed a large kidney stone that had to removed surgically with general anesthesia.

My personal experience is that I felt the effects of the anesthesia for about three months. Both my concentration and recall were diminished. Although I could still function, the effects were disconcerting. Fortunately, the effects were temporary.

I suspect that the younger the patient, the greater the long term effects of general anesthesia. I also believe that there is a cumulative effect. The more often general anesthesia is used, the greater the likelihood that memory will be effected.

The Bottom Line:
How do we address this issue? First, make the public aware that the issue exists. Second, avoid general anesthesia whenever possible, especially in the young.

I had a vasectomy at the age of 50 with local anesthesia only. Many of my friends and patients that have had vasectomies opted for general anesthesia out of fear of the pain. Honestly, the procedure was virtually painless. The recovery was a bit worse but tolerable and pain resolved in a couple of days.

Source: January 20 2016 National Institutes of Health

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