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The aging brain and anesthesia

机译：大脑衰老与麻醉

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PURPOSE OF REVIEW: To review the neurophysiology and neuroanatomy of normal aging and the recent recommendations for the clinical management of general anesthesia and sedation in the elderly. RECENT FINDINGS: As the population ages, the number of elderly patients having surgery is likewise increasing and with it, the prevalence of postoperative cognitive disorders. Postoperative cognitive disorders including delirium and postoperative cognitive dysfunction are common postanesthesia complications in elderly patients. Several risk factors for postoperative disorders have been identified, and anesthesiologists commonly adapt their practice habits when taking care of elderly patients to try to mitigate the effects of the anesthetics on postoperative cognitive function. These practices are reasonable and prudent; yet, they are not well supported by an understanding of the aging brain and specifics of how the anesthetic effects on the brain change with age. Through functional imaging and electrophysiological studies, much is being learned about the neurophysiology and the neuroanatomy of normal aging. SUMMARY: Our analysis suggests that understanding the neurophysiology and neuroanatomy should be part of the standard working knowledge of anesthesiologists and that this knowledge can guide their use of the electroencephalogram to track more accurately the brain states of elderly patients receiving anesthesia care.
机译：审查目的：审查正常衰老的神经生理学和神经解剖学，以及对老年人全身麻醉和镇静的临床管理的最新建议。最近的发现：随着人口的老龄化，接受手术治疗的老年患者数量也在增加，随之而来的是术后认知障碍的患病率。老年患者常见的麻醉后并发症包括including妄和术后认知功能障碍。已经确定了几种术后疾病的危险因素，麻醉医生在照顾老年患者时通常会适应其实践习惯，以减轻麻醉剂对术后认知功能的影响。这些做法是合理和审慎的;然而，对衰老的大脑以及麻醉剂对大脑的影响如何随年龄变化的理解并不能很好地支持它们。通过功能性成像和电生理学研究，人们已经学到了很多有关正常衰老的神经生理学和神经解剖学的知识。摘要：我们的分析表明，了解神经生理学和神经解剖学应该成为麻醉师标准工作知识的一部分，并且该知识可以指导他们使用脑电图来更准确地跟踪接受麻醉护理的老年患者的脑部状态。

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