Should Seniors Avoid Anesthesia?

Surgery is a common life event. In fact, 60 to 70 percent of people will have at least one surgical procedure in their lifetime. The demographic most likely to go under the knife is older adults, who are also at the highest risk of anesthesia complications. Does this mean surgery is a bad idea?

Anesthesia Explained

When discussing medical topics, we often toss around the term "anesthesia" without really considering what it entails. Anesthesia is more of an umbrella term than a specific treatment. It covers any intervention that prevents a patient from feeling pain during a procedure.

If I asked you to describe an anesthesia treatment, I guarantee you'd tell me about an anesthesiologist in an operating room, paid to put people to sleep with a breathing mask. That image is correct in most cases. When undergoing surgery, patients are sedated with inhaled gas and vapors.

Typical anesthetic gases include:

• Nitrous oxide (known as "laughing gas")

• Sevoflurane

• Isoflurane

• Desflurane

Gas is not the only form of anesthesia, though. Sedation and pain relief can be administered via IV. Likewise, not every medical procedure requires the patient to be completely sedated. During c-sections, for instance, regional anesthesia is used. A spinal block, according to Yale Medicine, is a single injection into the spinal fluid. Blocks like this keep the patient awake and alert, but numb from the chest down.

The medical interventions mentioned above have made modern surgery possible. Without them, treatments like organ transplants and heart surgeries would be impossible. To call them life-saving would be an understatement!

Non-invasive forms of anesthesia may not receive much fanfare, but they're still important interventions in medicine. Topical lotions and sprays, eye drops, and skin patches are also forms of pain prevention that fall under the classification of anesthesia.

Anesthesia Risks At Any Age

Anesthesia may be a modern medical miracle, but it carries risks. To be clear, anesthesia carries risks for everyone, no matter the age. No medical intervention is 100% safe, and anesthesia is no exception.

There are common, but generally harmless, side effects. General anesthesia, or sedation during surgery, can cause reactions that usually go away within 24 hours.

According to the Cleveland Clinic, common temporary side effects of anesthesia include:

• Nausea and/or vomiting

• Sore throat

• Headache

• Fatigue

• Difficulty urinating

• Itching

• Chills

The majority of people who undergo anesthesia experience no ill side effects. However, some do unfortunately experience more serious reactions.

Documented negative side effects of anesthesia include:

• Anesthesia awareness

• Malignant hyperthermia

• Collapsed lung

• Nerve damage

Anesthesia Risks in Older Adults

Anesthesia risks increase with age, and there are a few different reasons behind this. The most notable reason has to do with medical conditions that are common in old age. Certain diseases and disorders increase anesthesia complications. Subsequently, these are also usually noted in older adults.

Medical conditions that increase anesthesia risk include:

• Heart disease

• Diabetes

• High blood pressure

• Obstructive sleep apnea

• Kidney problems

• COPD

It isn't just about diseases, though. Even the healthiest senior citizen is at risk of anesthesia issues simply because of age. As our bodies age, our organs and systems change. Older metabolisms process medications more slowly, leading to longer drug exposure. Lower lung capacity makes people prone to complications like a collapsed lung. Anesthesia also affects blood pressure, and an aged heart can struggle with the change.

Special Consideration: Post-Operative Delirium

We've talked about how anesthesia affects the physical body, but what about the mind? For some, anesthesia can have real cognitive consequences. Older adults are especially vulnerable.

There is a little-known anesthesia reaction called post-operative delirium. Post-operative delirium is a sudden state of mental confusion and memory trouble that affects up to 50% of older adults after surgery, according to the American Society of Anesthesiologists.

Symptoms of post-operative delirium include:

• Hallucinations

• Confusion and disorientation

• Agitation

• Lethargy

• Slurred speech

These symptoms can present as early as 10 minutes after anesthesia or as late as 7 days post-surgery. Typically, it's a temporary state and resolves itself in 24 to 72 hours. Unfortunately, for some, it can linger for weeks or months. In rare cases, it has been permanent. If lasting, it is called postoperative cognitive dysfunction, or POCD.

Certain risk factors make one vulnerable to postoperative delirium. Patients with existing memory issues, such as dementia or Alzheimer's, are at the highest risk. According to notable neurologist Dr. Matthew D. Gold, it's more common after age 60. It's also most likely after orthopedic and cardiac surgeries.

Should Seniors Avoid Anesthesia?

There isn't a clear "yes" or "no" to this question. Not every senior should avoid anesthesia. In fact, certain cases may mean surgery is the only available treatment. A life-saving surgery can't be skipped.

No blog post can tell you if anesthesia is the right decision. A conversation with all doctors and surgeons involved is needed. These professionals can discuss the cost and benefits of the surgery. Be sure to bring up any concerns about side effects and recommendations to ease them.

Do you need post-operative care for you or a loved one? Seniors Fix can provide a caregiver to aid your recovery at home. Call 240-744-0674 to schedule a free consultation.