Best anasthetic for older patients to avoid contributihng to any Alzheimers or other dementia?

In my practice, most procedures are performed using oral sedation with IM injections with local anesthesia. Most do very well and only remember some of the background music and brief parts of the conversations. If patients desire to be less aware, we also give patients the option of having IV sedation or general anesthesia with a board certified anesthesiologist. IV sedation gives the benefit of less awareness but still retains the ability to breathe on your own. Organ systems are not anesthetized with anesthetic gases unlike full general anesthesia where it can take days for normal function to return.

hi
you can get the procedure performed under local anesthesia using some oral sedation such as valium and a pain pill or under IV sedation where propofol is used, similar to whats done for colonoscopies. Both of these are very well tolerate and safe and make sure your surgeon is highly experiences in facelift surgeries so they are comfortable using these options. General anesthesia would not be recommended for you based on your concerns.

The best anesthetic for older patients is always a local anesthetic with or without oral pain medication. I prefer to do my facelifts and upper eyelid rejuvenation procedures in this fashion. Good luck!

For patients who are concerned about general anesthesia, local anesthesia offers a good alternative. In our clinic we actually perform 90% of all our facelifts awake under local anesthesia. You can check out our Youtube channel SixSurgery to see the videos, or follow us on our IG account where we post our procedures as well.

The best and gentlest anesthetic option for patients aiming to minimize potential cognitive effects is typically intravenous (IV) sedation, also known as twilight anesthesia, paired with local anesthesia. This approach is less invasive than general anesthesia and is less likely to affect brain function or accelerate the buildup of tau or clumps. For facial procedures such as facelifts, fat transfers, and lip lifts, many skilled facial plastic surgeons can perform surgery under local anesthesia with mild IV sedation, especially for healthy, non-smoking patients. Consult your surgeon to find out if you're a suitable candidate. If general anesthesia is necessary, you can still take steps to reduce cognitive risks. Discuss these steps and your preferences with your anesthesiologist and surgeon. Be sure to share your family history with them so they can tailor your care to prioritize brain safety.

The detrimental effects of anesthesia related to brain are likely from reduced oxygenation during the procedure. As long as you mention your concerns to the anesthesiologist they can make sure that your oxygen saturation remains high during the procedure and hence avoid any cognitive effects.
Regards
Dr. J

Minimizing anesthesia is always a good idea. This is why I perform all my facial aesthetic procedures under local anesthesia with moderate sedation. This includes facelifts, eyelid surgery, brow lifts, etc. If the surgeon is experienced in giving the local anesthesia by first blocking some of the sensory nerves, the discomfort is minimal. This is why I only use medicine for relieving the pain of injection and a sedative to remove the patient's anxiety. The surgeons who are not comfortable with local anesthesia techniques will tell you that you could not have the proper operation without general anesthesia or heavy sedation. This is not true.

There is no definitive evidence that general anesthesia will cause worsening dementia or accelerate Alzheimers. Having said that, there are plenty of stories of patients who said they have "brain fog" after general anesthesia. I have performed many facelifts, fat transfers, and lip lifts under pure local anesthesia and have also combined them with IV sedation with Versed/Propofol, etc. These options may be a consideration when undergoing this procedure and it is best to have a good conversation with your surgeon and anesthesiologist.

So there is really alot of ongoing research about the potential connection between neurocognitive decline and general anesthesia. Most associate it with the use of isoflurane and sevoflurane but there really is not any definitive evidence one way or the other.

If you are particularily risk adverse in this arena, you can consider local anesthesia which is possible for fat transfer and lip lift and neck lift and a little difficult with facelift but possible. you can also have pure propofol with iv sedation or an LMA during anesthesia to avoid inhalation agents. Keep in mind that there is not a conclusive study to definitively pick one method of anesthesia as safer than others for neurocognitive decline. Best of luck!!

There is no strong evidence that general anesthesia increases Alzheimer risk. Having said that, I do 99% of my facial rejuvenation cases under twilight anesthesia which involves sedation with sleeping pills, pain medicine and an anti histamine. Local anesthesia is also used. There are many ways to do anesthesia but in general, less is more as long as the patient is comfortable. Talk to your surgeon about your concerns and using the least amount of anesthesia possible.

Best of Luck,

Dr. J

Hello, Sheila. You like many of my patients share concerns with intensive anesthesia, especially if it is not necessary. General anesthesia will use inhaled anesthetics that are administered through a breathing tube. Many of these anesthetic agents have been studied in animals and humans and found to have some neurotoxic effects. I almost never use general anesthesia for facelifts. Routinely I will perform a deep plane facelift, blepharoplasty, brow lift, fat transfer lip lift and laser resurfacing using IV sedation only. This form of anesthesia has an anesthesiologist monitoring you the entire time, titrating the precise dose of anesthetic to assure you are completely unaware of any of the procedure, don't feel anything and don't wake up during the procedure. Patients don't have the days of grogginess and nausea associated with a general anesthesia when the twilight IV sedation is used. It does take a highly experienced anesthesiologist and closely working team to allow this to work optimally. I've been performing facelifts in this fashion for over 20 years and patients are so relieved to know they don't need a general. Hope that helps.