Anesthesia Side Effects in Elderly Patients After Surgery

Anesthesia side effects

Hello: My father is 83 years old and had a mild stroke on July 28, 1990 (CT scan showed 2-4cc of bleeding in the right thalamus, but fortunately he is able to move around).
His condition was relatively good until yesterday when he fell, and although he did not hit his head, he fractured his femur while sitting down.
He just underwent surgery to have a metal rod inserted.

I have several questions:
1.
After the surgery (which was under general anesthesia), he has been acting differently, claiming that family members and those around him want to harm him.
He has never expressed such strange thoughts before (he was a doctor).

2.
What is the feasibility of such surgeries in elderly patients?
3.
Could this behavior be a side effect of anesthesia? Will it persist after recovery?
4.
If so, should this be considered a psychiatric disorder?
These behaviors have never occurred before, and he has never made similar strange statements.
Our family feels frightened and hopes the doctor can provide answers to help us cope.
Thank you.

Deng'r, 80~89 year old female. Ask Date: 2002/04/15

Dr. Tu Kuncun reply Anesthesiology

1.
It is common for elderly individuals to undergo surgical fixation with steel nails for femoral fractures.

2.
After general anesthesia, there is a possibility of complications due to the use of medications and the slower metabolism of drugs in elderly patients.
You can communicate directly with your father's anesthesiologist regarding your concerns.
Thank you for your question.

Reply Date: 2002/04/15

More Info

Understanding anesthesia side effects in elderly patients, especially after surgery, is crucial for both patients and their families. Your father's recent experience following surgery raises several important points about the effects of anesthesia, particularly in older adults.

1. Postoperative Behavioral Changes: It's not uncommon for elderly patients to exhibit unusual behavior or confusion after undergoing general anesthesia. This phenomenon, often referred to as postoperative delirium, can manifest as disorientation, hallucinations, or paranoia, as you described with your father. Factors contributing to this include the effects of anesthesia on the brain, pre-existing cognitive impairment, and the stress of surgery. In older adults, the brain may react differently to anesthetic agents, leading to these temporary changes in behavior. While these symptoms can be alarming, they are often transient and may resolve as the anesthetic agents are metabolized and the patient recovers.

2. Surgical Feasibility in Elderly Patients: The feasibility of surgery in elderly patients, particularly those with a history of stroke or other health issues, depends on several factors, including the patient's overall health, the type of surgery, and the potential risks involved. In your father's case, the decision to proceed with surgery likely involved a careful assessment by the surgical team, weighing the benefits against the risks. Generally, many elderly patients can safely undergo surgery, but they may require closer monitoring and tailored anesthetic approaches to minimize complications.

3. Anesthesia Aftereffects: The symptoms your father is experiencing could indeed be related to the anesthesia. Delirium is more common in older adults and can be exacerbated by factors such as dehydration, pain, medications, and the environment of the hospital. While some patients may experience these effects for a short period, others may take longer to fully recover. It is essential to monitor your father's condition closely and communicate any ongoing symptoms to his healthcare team. They can provide guidance on managing these effects and ensuring a supportive recovery environment.

4. Mental Health Considerations: The unusual statements and behaviors exhibited by your father post-surgery may not necessarily indicate a permanent mental health issue. However, it is essential to differentiate between temporary postoperative delirium and underlying psychiatric conditions. If these behaviors persist beyond the immediate recovery period, or if there are concerns about his mental health, a comprehensive evaluation by a geriatrician or psychiatrist may be warranted. They can assess for any cognitive decline or other mental health issues that may need to be addressed.

In summary, while the postoperative changes your father is experiencing can be distressing, they are not uncommon in elderly patients following anesthesia. It is crucial to maintain open communication with his healthcare providers to monitor his recovery and address any concerns. With appropriate care and support, many patients can return to their baseline functioning after surgery.

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