• James E Cottrell and John Hartung.
• State University of New York at Downstate Medical Center, Brooklyn, NY, USA. james.cottrell@downstate.edu
• Mt. Sinai J. Med. 2012 Jan 1;79(1):75-94.

AbstractThe assumption that anesthesia has no serious, long-term, adverse central nervous system consequences may be true for most patients between 6 months and 60 years of age. However, for patients younger than 6 months or older than 60 years, that status quo assumption is under challenge from a growing body of evidence. Fetuses and newborns appear to be at risk because systems that would enable them to fully recover from the effects of more than 2 hours of anesthesia are still in development. In distinction, the elderly appear to be at risk because systems that once enabled them to fully recover have ever-diminishing capacity. Even for those between the age of 6 months and 60 years, full recovery may require replacing apoptosed neurons and pruning overabundant dendritic spines…perhaps leaving patients not quite the same person that they were before they were anesthetized.© 2012 Mount Sinai School of Medicine.

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