Expert: Ronald Levy, M.D. - 9/13/2010

Question
Dr Levy,

With regards to your response to an individual's question re her "brain fog" subsequent to 8? surgeries and several months following a skiing accident and your assertion that her complaint is most likely the result of a TBI sustained from injury--  I have been hearing the same thing from "people" for the past several years myself regarding the long-term/ cumulative effects of general anesthesia. I still have not yet read such, but did recently receive confirmation from a neurogenetecist/ professor from a top neuroscience program that certain types of general anesthesia are typically bad news for people who HAVE suffered TBI's. I'm guessing that it would somehow further accelerate the secondary neuronal cell death occurring within the cabezas of such individuals. If you would please be willing to elucidate? I do realize that there are still issues with proper dx/ tx of TBI, as well as an increased need for proper education within the medical profession, esp re the neuropathological sequelae, including the brain cell necrosis. And similarly, what about the elderly, however "miniscule" the numbers (just like the incidence of adverse effects from the statins, etc...), some of whom develop at least a long-term psychosis and/ or dementia, the onset of which can be directly attributed to the anesthesia? I would be most appreciative of any meaningful response. THank you, sir!


Answer
First of all, I don't recall that particular response but as to the long term effects of anesthesia, nothing has been shown conclusively that there are any long term side effects (although there is a lot of stuff on the internet that says there is). I know that this is an area of active research by the ASA, so perhaps in a few years we'll have better information.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston