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Thursday, December 5, 2013
Effects Of Anesthesia On An Aneurysm
My father in law has an aneurysm about 5 centimeter in his groin area. He is worried about the effects of anesthesia, memory loss, etc. Is this a big concern -- he is 76 years old? He also, had MRSA, a blood infection. This occurred the last time he had surgery. It was treated and has not come back, but he is concerned about this reoccurring. If it comes back, will it be worse that the doctors won`t be able to fight it with antibotics? Just wondering how much of this is harmful fenought to stop him from taking care of the aneurysm?
The correct spelling is aneurysm, which is an abnormal enlargement of an artery. Aneurysms can burst. The larger they get the bigger the risk of bursting. An aneurysm of the aorta that is larger than 6 cm in diameter is considered to be at high risk of bursting but aneurysms of smaller size can burst also. An aortic aneurysm that bursts is often fatal even if treated quickly (this is a real surgical emergency).
Against the risk of a burst aneurysm you must consider the risks of the procedure, which relate to the risk both of the surgery and of the anesthesia. The surgical risks should be discussed with your surgeon. There are different risks based on the type of surgery (placing a stent is now an option instead of an "open" operation) and the experience and skill of the surgical team. Infection after vascular surgery should be uncommon but can happen.
MRSA is a resistant staph germ which is particularly difficult to treat should infection occur, and can be deadly. Some hospitals will screen people, particularly those who have previously had MRSA, for the presence of this germ, which is often carried in the nasal passages. If still present MRSA can be eliminated through antibiotics applied to the nose, and antiseptic body washes before surgery. Prevention is better than cure.
The risk of memory loss is difficult to assess. Aortic aneurysm is a big surgery usually done in elderly patients who seem to be at risk for this complication. However we do not have any objective way to determine those who are at particular risk, or ways to prevent memory loss from occurring.
For a full discussion of the risks that apply to your father-in-law he should see his surgeon and also his anesthesiologist to help make a decision. Go with him to help him understand all the information you will be given. Make notes and ask for written handouts.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University