Cognitive Impairment following use of Anaesthetic Agents: a Review of the Literature, and Implications for Future Practice.

Emerging data suggest that both inhalational and intravenous anaesthetics are associated with cognitive decline, particularly in the elderly. Of particular concern, is the phenomenon known as post-operative cognitive decline (POCD), characterised by a transient impairment of memory, concentration, language comprehension and social integration. Implicated in the pathophysiology of POCD is the accumulation of Aβ peptide, and inhibition of cholinergic neurotransmission. Currently used anaesthetic agents differ in their propensity for causing POCD as a result of their differing pharmacological profiles. Coupled with increasing knowledge of patient susceptibility factors, this information allows for modification of clinical practice to minimise the long-term disability that may otherwise accompany POCD.