Home HealthTopics Health Centers Reference Library Research
Join us on Facebook Join us on Facebook Share on Facebook
Share

Anesthesia

Life after Anesthesia

06/24/2003

Question:

My fiance underwent a heart valve replacement. He remained unconscious for nearly 12 hours AFTER surgery. I`ve heard that there are effects to the body after anesthesia used during surgery. What are they? And what can we expect in the way of physical or psychological effects of this, if any?

Answer:

Thanks for your question. Until a few years ago, it was common practice to deliberately keep patients unconscious at least until the day after open heart surgery. Today, it is usual to try to minimize this time during which the patient is kept heavily sedated and on a ventilator (breathing machine). Even so, most patients who undergo open heart surgery will be sedated, or even unconscious, for a period of hours after the surgery. So the fact that your fiance was in this state does not necessarily indicate that there was a problem with the surgery or during the recovery period. Sedation is used to buy time needed for recovery and stabilization of various body systems - lungs, heart, kidneys and brain - and for the elimination of anesthetic drugs. We think that a prolonged anesthetic in itself rarely produces any long term physical or psychological problems. However, there is a very limited amount of evidence emerging that suggests that elderly patients may have more cognitive difficulties after general anesthesia than younger patients. It is not clear whether these changes are sustained. The problem is the difficulty of distinguishing between the effects of the surgery and the effects of the anesthesia - the two go together. We cannot study the effects of the surgery alone because few patients would volunteer to undergo surgery without anesthesia! Many of the problems attributed to the anesthetic may in fact be due to the stress of the surgical procedure and the recovery from it. You should know also that heart surgery, and especially heart valve surgery, is a special case in that most patients will go on cardiopulmonary bypass (heart lung machine). The effects of the bypass machine on blood and oxygen supply to the brain may themselves lead to psychological problems, including memory loss and difficulty with thinking. Recent evidence suggests that the dislodgement of small particles of plaque from the walls of the aorta into blood vessels that supply the brain may be more of a culprit for these changes than the bypass machine, or, for that matter, the anesthetic drugs. 

For more information:

Go to the Anesthesia health topic, where you can:

Response by:

Case Western Reserve University Gareth S Kantor, MD
Assistant Professor of Anesthesiology
Anesthesiology and Perioperative Medicine
School of Medicine
Case Western Reserve University
Gareth S Kantor, MD