Olfactory disorders after general anesthesia

Friedrich, Hergen; Caversaccio, Marco; Landis, Basile Nicolas

doi:10.1016/j.jclinane.2012.07.002

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…Although reports have suggested that general anesthesia has no major effect on olfaction, 17,18 other studies have indicated impaired olfactory identification and loss of olfaction in patients receiving anesthetic agents. [13][14][15]17 Consistent with previous studies, cognitive impairment was observed in mice exposed to repeated isoflurane in the present study. More importantly, we showed that although olfactory preference/avoidance was not affected, olfactory detection and odor threshold were impaired by repeated isoflurane exposure in mice, providing important insights into the effects of repeated anesthetic exposure on olfaction of adult rodents.…”

Section: Discussionsupporting

confidence: 93%

“…11 Many human studies have also reported olfactory dysfunction after general anesthesia. [12][13][14][15][16] Conversely, several studies have indicated that general anesthesia has no effect on olfaction. 17,18 Therefore, whether and how general anesthesia affects olfactory behaviors remains poorly understood.…”

Section: Introductionmentioning

confidence: 99%

“…Many human studies have also reported olfactory dysfunction after general anesthesia 12–16 . Conversely, several studies have indicated that general anesthesia has no effect on olfaction 17,18 .…”

Section: Introductionmentioning

confidence: 99%

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Isoflurane impairs olfaction by increasing neuronal activity in the olfactory bulb

Zhou

et al. 2023

Acta Physiologica

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Aim: General anesthesia can induce cognitive deficits in both humans and rodents, correlating with pathological alterations in the hippocampus. However, whether general anesthesia affects olfactory behaviors remains controversial as clinical studies have produced inconsistent results. Therefore, we aimed to investigate how olfactory behaviors and neuronal activity are affected by isoflurane exposure in adult mice. Methods:The olfactory detection test, olfactory sensitivity test, and olfactory preference/avoidance test were used to examine olfactory function. In vivo electrophysiology was performed in awake, head-fixed mice to record single-unit spiking and local field potentials in the olfactory bulb (OB). We also performed patch-clamp recordings of mitral cell activity. For morphological studies, immunofluorescence and Golgi-Cox staining were applied.Results: Repeated exposure to isoflurane impaired olfactory detection in adult mice. The main olfactory epithelium, the first region exposed to anesthetics, displayed increased proliferation of basal stem cells. In the OB, a crucial hub for olfactory processing, repeated isoflurane exposure increased the odor responses of mitral/tufted cells. Furthermore, the odor-evoked high gamma response was decreased after isoflurane exposure. Whole-cell recordings further indicated that repeated isoflurane exposure increased the excitability of mitral cells, which may be due to weakened inhibitory input in isoflurane-exposed mice. In addition, elevated astrocyte activation and glutamate transporter-1 expression in the OB were observed in isoflurane-exposed mice.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Isoflurane impairs olfaction by increasing neuronal activity in the olfactory bulb

Zhou

et al. 2023

Acta Physiologica

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“…Right after surgery, with the associated pain, discomfort due to intubation, nasal mucosa edema, and temporary edema or malfunction of the olfactory system, many patients complain about temporary olfactory dysfunction. This is usually not permanent and disappears in a couple of days 8) . Sixteen of the 63 patients displayed olfactory dysfunction 5 months after surgery.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Efficacy of Olfactory Protection Using Gelfoam and Fibrin Glue during Anterior Communicating Artery Aneurysm Surgery

Cho

Yeon

et al. 2015

J Korean Neurosurg Soc

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ObjectivePatients treated with surgical clipping for anterior communicating artery (A-com) aneurysm often complain of anosmia, which can markedly impede their quality of life. We introduce a simple and useful technique to reduce postoperative olfactory dysfunction in A-com aneurysm surgery.MethodsWe retrospectively reviewed the medical records of patients who underwent surgical clipping for unruptured aneurysm from 2011-2013 by the same senior attending physician. Since March 2012, olfactory protection using gelfoam and fibrin glue was applied in A-com aneurysm surgery. Therefore we categorized patients in two groups from this time-protected group and unprotected group.ResultsOf the 63 enrolled patients, 16 patients showed postoperative olfactory dysfunction-including 8 anosmia patients (protected group : unprotected group=1 : 7) and 8 hyposmia patients (protected group : unprotected group=2 : 6). Thirty five patients who received olfactory protection during surgery showed a lower rate of anosmia (p=0.037, OR 10.516, 95% CI 1.159-95.449) and olfactory dysfunction (p=0.003, OR 8.693, 95% CI 2.138-35.356). Superior direction of the aneurysm was also associated with a risk of olfactory dysfunction (p=0.015, OR 5.535, 95% CI 1.390-22.039).ConclusionSuperior direction of aneurysm appears associated with postoperative olfactory dysfunction. Olfactory protection using gelfoam and fibrin glue could be a simple, safe, and useful method to preserve olfactory function during A-com aneurysm surgery.

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“…To date, there are several case reports of reversible anosmia and taste dysfunction following surgery and exposure to anaesthetic agents thereby suggesting a possible relationship between anaesthetic agents and altered olfactory function. [ 1 2 ] These postoperative manifestations are ascribed to the specific action of general anaesthetics on the brain neuronal system such as modulation of ion channels, mainly Gamma-aminobutyric acid (GABA) and N-methyl-D-aspartate (NMDA) receptors. [ 3 ] Olfaction is mediated by G-protein–cAMP coupled receptors in the cilia of olfactory receptor neurons in the neuroepithelium.…”

Section: Introductionmentioning

confidence: 99%

Effect of anaesthetic agents on olfactory threshold and identification – A single blinded randomised controlled study

et al. 2018

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Background and Aims:Anaesthetics are implicated in cognitive dysfunction, taste and odour deficits in the postoperative period. We aimed to assess the effect of isoflurane, sevoflurane, propofol and regional anaesthesia on the olfactory threshold, olfactory identification and endocrine regulation of associative memory in the postoperative period.Methods:In this observer-blinded randomised controlled study, 164 patients (>50 years) with the American Society of Anesthesiologists I and II status were randomised into one of four groups to receive regional anaesthesia, general anaesthesia with sevoflurane, general anaesthesia with isoflurane and total intravenous anaesthesia with propofol. Hindi Mental State Examination, olfactory threshold and olfactory identification were tested at 12 h preoperatively (T0), at 3 h postoperatively (T1) and at the time of discharge or postoperative day 3 (T2). In addition, serum melatonin levels were estimated at T0 and T1. The olfactory threshold was tested with n-butyl alcohol and olfactory identification with the University of Pennsylvania Smell Identification Test (UPSIT). Data were analysed using the one-way analysis of variance, Kruskal-Wallis or Mann-whitney tests.Results:The olfactory identification scores were lower with patients receiving sevoflurane-based anaesthesia at 3 h postoperatively (T1) when compared to preoperative (T0) (median 19.5 vs. 22; P = 0.01). This was accompanied by a significant postoperative reduction of plasma melatonin levels in sevoflurane group when compared to other groups (17.34 ± 4.8 pg/ml vs 23.2 ± 3.5 pg/ml; P < 0.001).Conclusion:Sevoflurane was associated with short-term olfactory identification impairment with a concomitant reduction in melatonin levels illustrating a possible humoral mechanism.

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Olfactory disorders after general anesthesia

Cited by 5 publications

References 10 publications

Isoflurane impairs olfaction by increasing neuronal activity in the olfactory bulb

Isoflurane impairs olfaction by increasing neuronal activity in the olfactory bulb

Feasibility and Efficacy of Olfactory Protection Using Gelfoam and Fibrin Glue during Anterior Communicating Artery Aneurysm Surgery

Effect of anaesthetic agents on olfactory threshold and identification – A single blinded randomised controlled study

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