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Cognitive Impairment After Anesthesia and Surgery
By Paula Sotir
Cognitive impairment after anesthesia and surgery (postoperative cognitive dysfunction, [POCD]) is a recognized clinical occurrence. In the majority of cases, POCD is short-lived and does not cause long-lasting side effects. However, this is not always the case with older adults. Age is one of the determining factors in how long and how severe POCD can be.
POCD is defined as a new cognitive impairment arising after a surgical procedure. It is a serious condition that can lead to long-term memory loss. Its diagnosis requires both pre- and postoperative testing. There is still much research to be completed, but it has been determined that certain conditions, such as heart disease, lung disease, Alzheimer’s, Parkinson’s and having had a previous stroke all increase the elder patients risk for POCD.
Senior patients considering surgery with general anesthesia should be sure to have an in-depth discussion with their physician and their anesthesiologist about any conditions that might put them at increased risk for incurring POCD. It is also advisable that a loved one or patient advocate attend the pre-surgery meeting with the senior to offer additional information as well as to clearly hear all of the risks. Sharing valuable information, (all health conditions and medications), both from patient to physician and vice versa will definitely contribute to the likelihood of a positive outcome.
General anesthesia is typically safe. While POCD is not a common occurrence, it is important to understand the risks associated with anesthesia. Most seniors will do fine, but many may experience post-op confusion and have trouble remembering things. This is a temporary condition (not POCD) and usually only lasts for a few days. Those caring for seniors post-surgery should be well-versed in the symptoms of postoperative cognitive dysfunction and they are prepared to have discussions with your physician should symptoms of POCD remain after recovery. Good communication, awareness of the senior’s medical history and being educated about post-operative symptoms will help make the senior patient’s recovery after surgery as successful as possible.