The Effects of Isoflurane and Desflurane on Cognitive Function in Humans

Abstract

BACKGROUND: The etiology of postoperative cognitive decline (POCD) remains to be determined. Anesthetic isoflurane, but not desflurane, may induce neurotoxicity. However, the functional consequences of these effects have not been assessed. We therefore performed a pilot study to determine the effects of isoflurane and desflurane on cognitive function in humans. METHODS: The subjects included patients who had lower extremity or abdominal surgery under spinal anesthesia alone (S, n = 15), spinal plus desflurane anesthesia (SD, n = 15), or spinal plus isoflurane anesthesia (SI, n = 15) by randomization. Each of the subjects received cognitive tests immediately before and 1 week after anesthesia and surgery administered by an investigator who was blinded to the anesthesia regimen. POCD was defined using the scores from each of these tests. RESULTS: We studied 45 subjects, 24 males and 21 females. The mean age of the subjects was 69.0 ± 1.9 years. There was no significant difference in age and other characteristics among the treatment arms. The mean number of cognitive function declines in the S, SD, and SI groups was 1.13, 1.07, and 1.40, respectively. POCD incidence after SI (27%), but not SD (0%), anesthesia was higher than that after S (0%), P = 0.028 (3-way comparison). CONCLUSION: These findings from our pilot study suggest that isoflurane and desflurane may have different effects on postoperative cognitive function, and additional studies with a larger sample size and longer times of follow-up testing are needed.

Isoflurane and sevoflurane increase interleukin-6 levels through the nuclear factor-kappa B pathway in neuroglioma cells

“…increasing IL-6 levels in the brain tissues of mice), 9 which could contribute to the isoflurane-associated decline in cognitive function in rodents 5 -7 and possibly humans. 8 However, it is largely unknown how isoflurane increases IL-6 levels. We, therefore, established a cellular system to determine the mechanism by which isoflurane increases IL-6 using H4 cells.…”

P1‐081: Chronic Treatment With Anesthetic Propofol Attenuates B‐amyloid Protein Levels in Brain Tissues of Aged Mice

“…Some anesthetics, e.g., isoflurane, have been shown to induce neurotoxicity and neurobehavioral deficits in vitro and in vivo [25,[33][34][35][36][37][38][39][40][41][42][43][44][45][46]. Therefore, the current findings that propofol attenuated Aβ levels in brain tissues of mice suggested that more studies are needed to assess whether propofol could be a better choice when providing anesthesia care for AD patients or senior patients who are vulnerable to develop postoperative cognitive dysfunction.…”

Effects of anesthesia type on short-term postoperative cognitive function in obstetric patients following cesarean section

“…They reported that patients with low intraoperative BIS values had less impairment in cognitive functions during postoperative 4-6 weeks. In the study by Zhang et al (29), it was suggested that BIS values of the groups who received general anesthesia and those who received spinal anesthesia were similar, but because the degrees of cognitive function impairments were different, the depth of anesthesia may not affect POCD. In our study, higher BIS values of the spinal anesthesia group compared with the general anesthesia group was an expected result, whereas extubation and post-extubation 5 th -minute BIS values of the desflurane group were significantly higher than those of the sevoflurane group.…”