Thursday, April 24, 2014
Shortened Life Span After Anesthesia
My mother tells me that she was told her life span decreases ever time she gets put under general anesthesia? Is this true?
This is not true unless you decide that you're not fully alive while you are under anesthesia and hence the time under anesthesia should be deducted from your lifespan.
Rather obviously, if you have a serious complication of anesthesia, this could result in your early mortality and hence a decreased life span.
There is an association between postoperative cognitive impairment (POCD) and increased mortality. POCD is a usually temporary condition, affecting concentration and memory, that occurs after surgery and anesthesia. POCD is much more common in the elderly.
POC is quite common in the days and weeks after surgery but in most cases resolves (gets better).
A Danish study showed that POCD that is still apparent 3 months after surgery is associated with about a 60% increase in mortality (death). In this study 20% of elderly patients had evidence of POCD at 1 week, dropping by half at 3 months. POCD is not necessarily due to anesthesia, because patients who have anesthesia are not randomly selected from the population - they are selected because they need surgery and hence have at least one other medical condition and usually more than one. There is speculation that POCD arises only in certain vulnerable elderly persons (e.g. early Alzheimer's disease) and is due to an interaction between anesthesia, and other drugs given before, during and after surgery, and the stress of surgery itself. Against the risk of anesthesia and surgery must be weighed the often life-saving benefits of anesthesia and surgery. POCD is being actively investigated around the world so hopefully we'll have better information on how to prevent and/or treat it in the future.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University