The inhibition of central nicotinic nAch receptors is the possible cause of prolonged cognitive impairment after anesthesia.

A growing number of data have shown that compounds interacting with nicotinic acetylcholine (nAch) receptors, present in the central nervous system, modulate cognitive functions. Treatment with nAch receptors agonists elicits long-lasting improvement of cognitive performance in a variety of behavioral tests in animals and humans, while nicotinic receptor blockade can impair memory. The causes of cognitive dysfunction could be consistent with the potent inhibition of certain anesthetics on nicotinic nAch receptors. Moreover, because the cognitive impairment in the general anesthesia suggests a negative effect of either the general anesthetic agents or the postoperative analgesic regimen, postoperative cognitive dysfunction must be related to drugs administered and not to the general anesthesia itself.