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From the *Department of Anesthesiology, Cheil General Hospital, and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea; Department of Anesthesia, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts; Wellcome Trust Senior Research Fellow, Oxford University, Oxford, UK; Department of Anesthesia, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts; and ||Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Genetics and Aging Research Unit, Charlestown, Massachusetts.
Address correspondence and reprint requests to Dr. Crosby, Laboratory for Aging Neuroscience, Department of Anesthesiology, Brigham and Women’s Hospital, 75 Francis St. Boston, MA 02115. Address e-mail to gcrosby{at}zeus.bwh.harvard.edu.
BACKGROUND: We have previously demonstrated that aged rats have persistent impairment of spatial memory after sedation with nitrous oxide or general anesthesia with isoflurane-nitrous oxide. Propofol has different receptor mechanisms of action and a favorable short-term recovery profile, and it has been proposed that propofol is devoid of enduring effects on cognitive performance. No studies have investigated this question in aged subjects, however, so we designed an experiment to examine the long-term effects of propofol anesthesia on spatial working memory.
METHODS: Eighteen-mo-old rats were randomized to 2 h of 100% oxygen-propofol anesthesia (n = 11) or to a control group that breathed 100% oxygen (n = 10). Propofol was administered by continuous infusion via a tail vein catheter. Rats breathed spontaneously and rectal temperature was maintained. Mean arterial blood pressure was measured noninvasively and a venous blood gas was obtained just before discontinuation of propofol. After a 2-day recovery, spatial working memory was assessed for 14 days using a 12-arm radial maze. The number of total errors, number of correct choices to first error, and time to complete the maze was recorded and analyzed using a repeated measure analysis of variance (ANOVA), with P < 0.05 being considered statistically significant.
RESULTS: The average propofol infusion rate was 0.6 ± 0.1 mg · kg –1 · min–1, a rate corresponding to a 50% effective concentration dose in adult rats. Mean arterial blood pressure during anesthesia was 100 ± 2 mm Hg and venous blood gases remained in the normal range. There was no difference between the control and previously anesthetized rats on any measure of radial arm maze performance, indicating propofol anesthesia produces no lasting impairment in spatial working memory in aged rats.
CONCLUSIONS: In aged rats, propofol anesthesia is devoid of the persistent memory effects observed with other general anesthetics in this model. Thus, while it appears that the state of general anesthesia is neither necessary nor sufficient for development of postanesthetic memory impairment, the choice of anesthetics may play a role in late cognitive outcome in the aged.
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