Seniors

Do the risks of anesthesia increase in older adults? Approximately 1/3 of surgical patients in the United States are over the age of 65. Being older can increase your risk of side effects or complications associated with surgery and anesthesia. Many of the complications that patients experience after surgery are related to diseases of aging themselves. However, there is concern that the aging brain is more easily affected by medications. Two anesthesia-related side effects that are more common in older people are postoperative delirium and postoperative cognitive dysfunction. What is postoperative delirium? After surgery, you may feel confused, have problems with memory or focus. These symptoms may come and go in the hours and days after an operation, and usually resolve within a week after your surgery. The causes of delirium in the hospital are usually related to injury, medications, and disrupted sleep schedule. There are steps to help decrease the risk of delirium after an operation. You can ask a family member to stay with you if you will be in the hospital overnight. It is also helpful, if you use glasses or hearing aids, for you to bring them to the hospital. When you are in your hospital room, try to keep the blinds open during daylight hours. It is also helpful for you to bring personal items with you such as family photos or your weekly calendar. What is postoperative cognitive dysfunction (POCD)? Postoperative cognitive dysfunction is a spectrum of long-term memory problems, causing decreased ability to learn, concentrate, and think. Certain medical conditions can increase someone’s risk for POCD. These conditions are congestive heart failure, lung disease, Alzheimer’s disease, Parkinson’s disease, or a previous stroke. The causes of postoperative cognitive dysfunction are unclear, but may be related to the effects of anesthetic medications on the brain. How can I decrease my anesthesia risks? Your overall risk of general anesthesia may be decreased by caring for your major medical problems with regular visits to your primary care physician. Being seen by one of our anesthesia physicians in the pre-Anesthesia Clinic is also helpful to ensure that your health is optimum before your operation. There has been much research in past years comparing general and regional anesthesia regarding impact on postoperative cognitive impairment. Evidence is lacking that one method of anesthesia is superior. You will speak with your anesthesiologist before your surgery to help determine the anesthetic plan that best suits your needs.