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Postoperative Cognitive Function Following General Versus Regional Anesthesia: A Systematic Review

Davis, Nicholas MD*; Lee, Melissa MD*; Lin, Albert Y. MD, MPH*; Lynch, Lisa MD*; Monteleone, Matthew MD*; Falzon, Louise PGDipInf†,‡; Ispahany, Nighat MLS; Lei, Susan MD*

Journal of Neurosurgical Anesthesiology: October 2014 - Volume 26 - Issue 4 - p 369–376
doi: 10.1097/ANA.0000000000000120
Departments: Supplement: Fourth Pediatric Anesthesia and Neuro-Development Assessment (PANDA) Symposium

The effect of anesthetic technique on postoperative outcomes remains in question. This systematic review compares the role of regional versus general anesthesia, with a particular focus on postoperative cognitive function. Potentially relevant articles were identified by searching publicly available computerized databases for this systematic review. Any surgical procedure was accepted with the exception of cardiac, carotid, and neurosurgical procedures. Any regional anesthetic technique was accepted unless combined with a general anesthetic or in conjunction with propofol as a sedative. Any measure of postoperative cognitive function was accepted as long as it was performed no sooner than 7 days postoperatively. Sixteen studies met inclusion criteria and were included in the final analysis. Three studies showed some difference in cognitive function between regional and general anesthesia, whereas the remaining 13 showed no difference between regional and general anesthesia on postoperative cognitive function.

*Department of Anesthesiology

Center for Behavioral Cardiovascular Health

Augustus C. Long Health Sciences Library, Columbia University Medical Center, New York, NY

N.D. and M.L. contributed equally as first authors.

L.F. has salary support from the National Institutes of Health (Grant No. HL088117, P01HL047540 and K24 HL084034). The other authors have no conflicts of interest to disclose.

Reprints: Nicholas Davis, MD, Department of Anesthesiology, Columbia University Medical Center, 622 W. 168th St, PH 505, New York, NY 10032 (e-mail:

© 2014 by Lippincott Williams & Wilkins