by Mackenzie Thompson
Life Saver, AMC
posted on Mar 22, 2014, at 9:50 pm
OVER TWO YEARS AGO, when she was 81, Susan Baker had surgery done in her spine and was under anesthesia for three hours. She seemed to be recovering just fine but later that night, she hallucinated that there was a raging fire in the hospital. The next day, she was completely fine. For her, it was the most terrifying experience she has ever had.
Hallucinations, slowness, nonsense speaking, serious confusion and memory loss are symptoms of postoperative delirium, which is a state of serious confusion and memory loss that sometimes follows anesthesia the next couple days. Physicians have had knowledge of these possibilities for over 30 years, but they believed it not to be the fault of the anesthesia drugs but rather the stresses of surgery and hospitalization. In the past four years, studies have brought doubt on those presumptions and also have suggested that the conditions of memory and attention can last for months or even years.
There are three main types of anesthesia: local, regional and general. Local is used for numbing a small area, like a single tooth. Regional anesthesia is injected into the spine to block nerve signals the brain and desensitizes a large section of the body. Usually, a sedative drug is taken along with regional anesthesia to make a person less responsive but not put them under. General anesthesia results in a patient being completely unconscious and immobile.
When postoperative delirium was first identified, it was thought that certain anesthetic drugs caused it. After numerous studies, there seemed to be no results that supported the theory that some drugs cause the severe conditions while others do not (though that is not to say that all of the drugs are favorable for every patient). Now, they are focusing on the amount of anesthesia instead of the type. Researchers suspect that the more patients receive and the deeper of an unconscious state they’re in, the more likely they are to endure delirium. There have been studies and experiments to test these theories, and some with supportive results.
Another study found that sometimes in a regional anesthesia combined with the sedative, 87% of the patients’ brain activity decreased enough to be categorized as general anesthesia. Frederick E. Sieber of the Johns Hopkins University School of Medicine, who with his colleagues performed the study, says he was astonished to find that it is not unusual for a patient getting regional anesthesia to end up in a state of general anesthesia.
Meanwhile, as clinicians are studying to learn more about postoperative delirium, they have a few strategies as preliminary precautions to try to decrease the risk. Doctors continuously oversee the patient’s brain activity by making sure they can respond to their name. Patient hydration and nourishment prior to the surgery is also important because it may improve blood flow to the brain. It is also suggested that the patient is slightly active throughout the next day and not just laying around for the duration, though different surgeries may affect that suggestion. Good sleep is vital for recovery, too. The use of medications that may alter brain activity is discouraged. Until more is discovered about the symptoms of postoperative delirium, it would be beneficial to follow the previous suggestions in hope for the best recovery after your surgery.
To read the full article, please visit Scientific American