Post-Anesthesia Complications: Confusion and Mood Changes After Surgery - Surgery

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Dear Doctor: My father, who is 78 years old, was diagnosed with colorectal cancer on August 19.
He underwent a total rectal and anal resection surgery at Shin Kong Hospital on August 26.
After the surgery, he exhibited confusion, restless sleep, and irritability, along with incoherent speech.
The surgery lasted a total of 6 hours.
I would like to ask if these reactions are normal and how long they might last.
He has been attempting to pull out his tubes, which has caused great concern for my family and me.
I would greatly appreciate your clarification on this matter.
Thank you very much.

Wu Anbang, 30~39 year old female. Ask Date: 2004/08/29

Dr. Hou Yongji reply Surgery


Hello: Based on your description, it's important to consider not only the anesthesia issues but also the psychological reactions caused by the stress of major surgery.
Additionally, physiological changes may occur due to electrolyte imbalances.
Please consult your father's attending physician.
Since you have chosen this hospital for treatment, it is essential to communicate with the doctor.
I believe your physician will be able to provide the best care for your father.

Reply Date: 2004/08/29

More Info


Post-anesthesia complications, particularly confusion and mood changes, are not uncommon after major surgeries, especially in older adults. Your father's experience following his surgery for colorectal cancer raises several important considerations regarding the effects of anesthesia and the surgical procedure itself.

Firstly, it is essential to understand that the brain's response to anesthesia can vary significantly among individuals, particularly in older patients. Age-related changes in brain function, along with pre-existing conditions, can contribute to postoperative confusion, often referred to as postoperative delirium. This condition can manifest as disorientation, agitation, and mood swings, which you have observed in your father. Factors such as the duration of the surgery (in this case, six hours), the type of anesthesia used, and the overall health status of the patient can all influence the likelihood and severity of these symptoms.

In your father's case, the combination of major surgery and the effects of anesthesia may have led to a temporary state of confusion and emotional instability. Postoperative delirium can be exacerbated by factors such as pain, discomfort, medication side effects, and the stress of the surgical experience. It is not uncommon for patients to experience fluctuations in their mental state during the recovery period, particularly in the first few days following surgery.

Regarding the duration of these symptoms, postoperative delirium can last from a few hours to several days, depending on the individual and the underlying causes. In many cases, these symptoms gradually improve as the patient recovers from the anesthesia and the surgical stress. However, it is crucial to monitor your father's condition closely, as prolonged confusion or agitation may require further evaluation by his healthcare team.

In addition to the effects of anesthesia, other factors may contribute to your father's postoperative state. For instance, electrolyte imbalances, dehydration, and pain management can all play significant roles in a patient's recovery. Ensuring that he is adequately hydrated and that his pain is managed effectively can help mitigate some of the confusion and agitation.

It is also important to communicate openly with your father's healthcare providers about your concerns. They can assess his condition more thoroughly and determine if any additional interventions are necessary. This may include adjusting medications, providing supportive care, or implementing strategies to enhance his comfort and orientation.

In summary, while your father's postoperative confusion and mood changes are concerning, they are not uncommon after major surgery, particularly in older adults. These symptoms are often temporary and can improve with time and appropriate care. However, ongoing monitoring and communication with his medical team are essential to ensure a safe and effective recovery. If symptoms persist or worsen, further evaluation may be warranted to rule out other underlying issues.

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