Age
Age may bring wisdom but it also brings a greater chance of health problems, and some health problems might require surgery to make you better. In fact, 1 in 10 people who have surgery are 65 or older.
While being older makes surgery more likely, it can also increase your potential for risks during procedures. Some common health problems related to aging — increased blood pressure, clogged arteries, and heart and lung disease — may make it more likely that you’ll experience side effects or complications during or after surgery. And, just being older sometimes can cause some distressing side effects.
Some common health problems related to aging may make it more likely that you’ll experience side effects or complications during or after surgery.
Do anesthesia risks increase in older adults?
One concern for older patients is that the aging brain is more vulnerable to anesthesia, medication that prevents you from feeling pain during surgery often by sedating you or making you lose consciousness. Here are two anesthesia-related surgery risks that are more common in older people:
- Postoperative delirium– This is a temporary condition that causes the patient to be confused, disoriented, and unaware of surroundings, and have problems with memory and paying attention. It may not start until a few days after surgery, may come and go, and usually disappears after about a week.
- Postoperative cognitive dysfunction (POCD)– This is a more serious condition that can lead to long-term memory loss and make it difficult to learn, concentrate, and think. Because some of these problems are already common in elderly people, the only way to determine if a patient actually has POCD is to conduct a mental test before surgery. Certain conditions, including heart disease (especially congestive heart failure), lung disease, Alzheimer’s disease, Parkinson’s disease, and having had a stroke in the past, increase your risk for POCD. Researchers in anesthesia care continue to study and learn more about these conditions and how to prevent or reduce the effects.
How can you reduce anesthesia risks in older patients?
The most important thing you can do to reduce risks of anesthesia is talk to your physician or surgeon to be sure your anesthesia care is led by an anesthesiologist.
You might also ask if there’s an anesthesiologist who specializes in geriatric patients, or has more experience with older patients, who can manage your care. Steps can be taken before, during and after surgery to help reduce your risks of developing age-related problems from anesthesia.
During your meeting with your anesthesiologist before surgery, be sure to talk about any health problems you might have, all the medications you take, including nutritional or herbal supplements, and any concerns or fears you might have about your surgery. Describe any surgeries you’ve had and any problems you may have experienced with anesthesia in the past. Also talk about any memory problems or thinking problems you may have experienced after having anesthesia.
It’s a good idea to have someone with you during these meetings, preferably a close family member or friend. This person could tell the anesthesiologist something you forgot to mention or didn’t think was important, and might also have helpful observations about your health or behavior. A second pair of ears will also help you remember what the anesthesiologist told you, including instructions for preparing for surgery.
Your anesthesiologist will use the information you provide to develop the best anesthesia care plan for you, to reduce your risk of complications, and then closely monitor you during the surgery.
Other steps you can take to eliminate complications and reduce confusion include the following:
- Ask your physician to conduct a pre-surgery cognitive test — an assessment of your mental function. The physician can use the results as a baseline for comparison after surgery.
- Be sure your caregiver or person who spends the most time with you stays with you as you recover, carefully observes your physical and mental activity after surgery and reports anything troubling to your physician.
- Check with your physician before taking medications after surgery that can affect your nervous system, such as those for anxiety, seizures, muscle spasms, and difficulty falling asleep.
- If you wear hearing aids or glasses, ask that they be made available to you as soon as possible after the procedure.
- Request a recovery room with a window if possible, so you can tell whether it’s day or night.
- If you will be staying overnight in the hospital, pack a family photo, a clock, and a calendar, or other familiar objects from home, to help you readjust.
See Preparing for Surgery for more information.
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Anesthesiologists work with your surgical team to evaluate, monitor, and supervise your care before, during, and after surgery—delivering anesthesia, leading the Anesthesia Care Team, and ensuring your optimal safety.
FAQs
Postoperative delirium – Confusion when regaining consciousness after surgery is common, but for some people — particularly older patients — the confusion can come and go for about a week. You may feel disoriented and have problems remembering or focusing.
What are the effects of anesthesia on the elderly? ›
Confusion is common after anesthesia
especially troubling for patients who may already be experiencing cognitive decline, dementia or memory problems. Patients may experience delirium at any point between the first few hours or even up to five days after treatment.
Can anesthesia cause lingering side effects? ›
However, some people suffer lingering effects in the days after anaesthesia. These include drowsiness, slowed reaction times, and difficulty concentrating, remembering new information and finishing complex tasks.
How long does it take for anesthesia to wear off in elderly? ›
Anesthetic drugs can stay in your system for up to 24 hours. If you've had sedation or regional or general anesthesia, you shouldn't return to work or drive until the drugs have left your body. After local anesthesia, you should be able to resume normal activities, as long as your healthcare provider says it's OK.
What are the risks of geriatric anesthesia? ›
Other complications
Elderly patients are vulnerable to hypothermia due to decreased basal metabolic rate and anaesthesia-induced altered thermoregulatory mechanisms. Hypothermia can lead to coagulopathy, increased blood loss, cardiac ischaemia, arrhythmias, poor wound healing and long hospital stay.
Is general anesthesia safe for a 70 year old? ›
One concern for older patients is that the aging brain is more vulnerable to anesthesia, medication that prevents you from feeling pain during surgery often by sedating you or making you lose consciousness.
Can anaesthesia cause cognitive disturbance in the elderly? ›
The results of the survival curve suggested that older adults with a history of surgery with general anesthesia would develop cognitive impairment earlier and more often (p = 0.013, HR = 1.506, 95% CI 1.091–2.078).
How long does it take for your body to fully recover from anesthesia? ›
Overview. It usually takes between 1 hour and 2 hours to wake up completely after a general anesthesia.
Can anesthesia make you feel bad for days? ›
When first waking from anesthesia, you may feel confused, drowsy, and foggy. This usually lasts for just a few hours, but for some people — especially older adults — confusion can last for days or weeks. Muscle aches. The drugs used to relax your muscles during surgery can cause soreness afterward.
What is a delayed effect of anesthesia? ›
Delayed emergence is defined as the failure to regain consciousness 30–60 minutes after general anesthesia, and the clinical presentation often involves both altered mental status and respiratory complications.
According to the United States Social Security Administration, anyone age 65 or older is elderly.
What is Sundowning after surgery? ›
In general, people with delirium may have difficulty concentrating on a single topic, are disoriented, and often have a reduced or fluctuating level of consciousness. Their disorientation and mental difficulties are often worse at night, a condition sometimes referred to as “sundowning.”
What is the most common post-op complication in the elderly? ›
Post-operative delirium is the most common complication of surgery for older adults, according to the American Geriatric Society, affecting up to 50% of seniors. If not identified early and treated, post-operative delirium can lead to long-term health issues, including cognitive decline and functional decline.
Who should not have anesthesia? ›
What factors make anesthesia riskier?
- Allergies to anesthesia or a history of adverse reactions to anesthesia.
- Diabetes.
- Heart disease (angina, valve disease, heart failure, or a previous heart attack)
- High blood pressure.
- Kidney problems.
- Lung conditions (asthma and chronic obstructive pulmonary disease, or COPD)
- Obesity.
Postoperative delirium or cognitive dysfunction – In some cases, confusion and memory loss can last longer than a few hours or days. A condition called postoperative cognitive dysfunction can result in long-term memory and learning problems in certain patients.
How long can anesthesia cause confusion in the elderly? ›
Post-operative delirium (POD) can occur from 10 minutes after anesthesia to up to 7 days in the hospital or until discharge. It is commonly recognized in the post-anesthesia care unit (PACU) as sudden, fluctuating, and usually reversible disturbance of mental status with some degree of inattention.
What age is considered high risk for surgery? ›
Major surgery carries risks for patients of all ages. However, people 65 and older are at a higher risk than younger adults for certain complications or side effects, according to the American Society of Anesthesiologists.
Who should not be put under anesthesia? ›
Your anesthesia risk might be higher if you have or have ever had any of the following conditions: Allergies to anesthesia or a history of adverse reactions to anesthesia. Diabetes. Heart disease (angina, valve disease, heart failure, or a previous heart attack)
What is the risk of sedation in the elderly? ›
They are commonly used in elderly patients due to their rapid onset and short duration of action. However, benzodiazepines can cause cognitive impairment, confusion, falls, and respiratory depression in elderly population. Therefore, they should be used with caution and at lower doses than younger adults.
