Neurological and Olfactory Disturbances After General Anesthesia

Neurological and olfactory disturbances are increasingly recognized as potential complications of general anesthesia, particularly in vulnerable populations, such as the elderly, children, and individuals with comorbidities. Recent studies have highlighted the need for tailored anesthetic approaches...

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Main Authors: Antonino Maniaci, Mario Lentini, Rosario Trombadore, Loris Gruppuso, Santo Milardi, Rosario Scrofani, Giuseppe Cuttone, Massimiliano Sorbello, Rodolfo Modica, Jerome R. Lechien, Paolo Boscolo-Rizzo, Daniele Salvatore Paternò, Luigi La Via
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Language:English
Published: MDPI AG 2025-02-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/3/344
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author Antonino Maniaci
Mario Lentini
Rosario Trombadore
Loris Gruppuso
Santo Milardi
Rosario Scrofani
Giuseppe Cuttone
Massimiliano Sorbello
Rodolfo Modica
Jerome R. Lechien
Paolo Boscolo-Rizzo
Daniele Salvatore Paternò
Luigi La Via
author_facet Antonino Maniaci
Mario Lentini
Rosario Trombadore
Loris Gruppuso
Santo Milardi
Rosario Scrofani
Giuseppe Cuttone
Massimiliano Sorbello
Rodolfo Modica
Jerome R. Lechien
Paolo Boscolo-Rizzo
Daniele Salvatore Paternò
Luigi La Via
author_sort Antonino Maniaci
collection DOAJ
description Neurological and olfactory disturbances are increasingly recognized as potential complications of general anesthesia, particularly in vulnerable populations, such as the elderly, children, and individuals with comorbidities. Recent studies have highlighted the need for tailored anesthetic approaches in these high-risk groups to mitigate potential long-term effects. These disturbances, including postoperative cognitive dysfunction, delirium, and olfactory deficits, often arise from shared pathophysiological mechanisms, such as neuroinflammation, oxidative stress, and disruptions in cerebral perfusion. The olfactory system is particularly susceptible to anesthesia-induced neurotoxicity given its proximity to central nervous system structures and its role in sensory and cognitive processing. Furthermore, the unique regenerative capacity of olfactory neurons may be compromised by prolonged or repeated exposure to anesthetic agents, potentially leading to long-term olfactory dysfunction. Risk factors, such as advanced age, neurodegenerative diseases, diabetes, cardiovascular conditions, genetic predispositions, and the type and duration of anesthesia exposure, further exacerbate these complications. Preventive strategies, including comprehensive preoperative risk assessment, personalized anesthetic protocols based on genetic and physiological profiles, and proactive postoperative care with early intervention programs, are critical for reducing impairments and improving long-term patient outcomes. Emerging evidence highlights the potential role of neuroprotective agents, such as antioxidants and anti-inflammatory therapies, in mitigating the effects of anesthesia-induced neurotoxicity. Longitudinal studies are needed to evaluate the long-term effects of anesthesia on cognitive and sensory health, particularly in high-risk populations. These studies should incorporate advanced neuroimaging techniques and biomarker analysis to elucidate the underlying mechanisms of anesthesia-induced neurological and olfactory disturbances. This narrative review provides a comprehensive overview of the mechanisms, risk factors, and preventive strategies for neurological and olfactory disturbances after general anesthesia and highlights future directions for research to improve patient outcomes. We conducted a comprehensive literature search using databases, such as PubMed and Scopus, to identify relevant studies.
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spelling doaj-art-d5afc5cef2ae46538ae61c05f211a66f2025-08-20T03:43:39ZengMDPI AGLife2075-17292025-02-0115334410.3390/life15030344Neurological and Olfactory Disturbances After General AnesthesiaAntonino Maniaci0Mario Lentini1Rosario Trombadore2Loris Gruppuso3Santo Milardi4Rosario Scrofani5Giuseppe Cuttone6Massimiliano Sorbello7Rodolfo Modica8Jerome R. Lechien9Paolo Boscolo-Rizzo10Daniele Salvatore Paternò11Luigi La Via12Deparment of Medicine and Surgery, University of Enna “Kore”, 94019 Enna, ItalyDeparment of Medicine and Surgery, University of Enna “Kore”, 94019 Enna, ItalyAsp 7 Ragusa, 97100 Ragusa, ItalyAsp 7 Ragusa, 97100 Ragusa, ItalyAsp 7 Ragusa, 97100 Ragusa, ItalyAsp 7 Ragusa, 97100 Ragusa, ItalyDeparment of Medicine and Surgery, University of Enna “Kore”, 94019 Enna, ItalyDeparment of Medicine and Surgery, University of Enna “Kore”, 94019 Enna, ItalyAsp 7 Ragusa, 97100 Ragusa, ItalyDivision of Laryngology and Bronchoesophagology, Department of Otolaryngology Head Neck Surgery, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, Faculty of Medicine, University of Mons (UMons), 7000 Mons, BelgiumDepartment of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34121 Trieste, ItalyAsp 7 Ragusa, 97100 Ragusa, ItalyDepartment of Anesthesia and Intensive Care, University Hospital Policlinico “G. Rodolico-San Marco”, 95123 Catania, ItalyNeurological and olfactory disturbances are increasingly recognized as potential complications of general anesthesia, particularly in vulnerable populations, such as the elderly, children, and individuals with comorbidities. Recent studies have highlighted the need for tailored anesthetic approaches in these high-risk groups to mitigate potential long-term effects. These disturbances, including postoperative cognitive dysfunction, delirium, and olfactory deficits, often arise from shared pathophysiological mechanisms, such as neuroinflammation, oxidative stress, and disruptions in cerebral perfusion. The olfactory system is particularly susceptible to anesthesia-induced neurotoxicity given its proximity to central nervous system structures and its role in sensory and cognitive processing. Furthermore, the unique regenerative capacity of olfactory neurons may be compromised by prolonged or repeated exposure to anesthetic agents, potentially leading to long-term olfactory dysfunction. Risk factors, such as advanced age, neurodegenerative diseases, diabetes, cardiovascular conditions, genetic predispositions, and the type and duration of anesthesia exposure, further exacerbate these complications. Preventive strategies, including comprehensive preoperative risk assessment, personalized anesthetic protocols based on genetic and physiological profiles, and proactive postoperative care with early intervention programs, are critical for reducing impairments and improving long-term patient outcomes. Emerging evidence highlights the potential role of neuroprotective agents, such as antioxidants and anti-inflammatory therapies, in mitigating the effects of anesthesia-induced neurotoxicity. Longitudinal studies are needed to evaluate the long-term effects of anesthesia on cognitive and sensory health, particularly in high-risk populations. These studies should incorporate advanced neuroimaging techniques and biomarker analysis to elucidate the underlying mechanisms of anesthesia-induced neurological and olfactory disturbances. This narrative review provides a comprehensive overview of the mechanisms, risk factors, and preventive strategies for neurological and olfactory disturbances after general anesthesia and highlights future directions for research to improve patient outcomes. We conducted a comprehensive literature search using databases, such as PubMed and Scopus, to identify relevant studies.https://www.mdpi.com/2075-1729/15/3/344general anesthesianeurological disturbancesolfactory dysfunctionpostoperative cognitive dysfunction (POCD)neuroinflammationoxidative stress
spellingShingle Antonino Maniaci
Mario Lentini
Rosario Trombadore
Loris Gruppuso
Santo Milardi
Rosario Scrofani
Giuseppe Cuttone
Massimiliano Sorbello
Rodolfo Modica
Jerome R. Lechien
Paolo Boscolo-Rizzo
Daniele Salvatore Paternò
Luigi La Via
Neurological and Olfactory Disturbances After General Anesthesia
Life
general anesthesia
neurological disturbances
olfactory dysfunction
postoperative cognitive dysfunction (POCD)
neuroinflammation
oxidative stress
title Neurological and Olfactory Disturbances After General Anesthesia
title_full Neurological and Olfactory Disturbances After General Anesthesia
title_fullStr Neurological and Olfactory Disturbances After General Anesthesia
title_full_unstemmed Neurological and Olfactory Disturbances After General Anesthesia
title_short Neurological and Olfactory Disturbances After General Anesthesia
title_sort neurological and olfactory disturbances after general anesthesia
topic general anesthesia
neurological disturbances
olfactory dysfunction
postoperative cognitive dysfunction (POCD)
neuroinflammation
oxidative stress
url https://www.mdpi.com/2075-1729/15/3/344
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