(RxWiki News) It's not odd to feel a little foggy headed after certain surgeries. But once the anesthesia has worn off, continued confusion may be a sign of a bigger problem. This type of confusion may lead to serious complications later.
A recent study looked at risk factors for serious confusion and lack of awareness in elderly patients after surgery.
The results of the study showed that increases in hormones involved with the stress response and/or having diabetes were risk factors for developing delirium after surgery.
"Tell your surgeon if you're stressed before surgery."
Stacie G. Deiner, MD, from the Icahn School of Medicine at Mount Sinai in New York, led this investigation into mental states of elderly patients right after surgery.
An altered mental state of confusion and lack of awareness of one’s surroundings can be defined as delirium. Just after having surgery, there is a risk for experiencing delirium.
According to the authors of this study, delirium just after surgery happens in 20 percent of elderly patients and 50 percent of high-risk patients. The authors defined high-risk patients as those who had been in an accident, such as falling and breaking a hip, or had already been receiving treatment in the intensive care unit (ICU) of a hospital.
Previous research has also linked post-surgical delirium to an increased risk for expensive complications after surgery and even death.
Past research also has suggested that a patient’s physiologic response to stress — through stress hormones — may increase the risk of developing post-surgical delirium.
For this study, the researchers followed 76 patients over the age of 68 who were having major, non-heart-related surgery.
All of the patients were tested for mental function and awareness before and after having surgery.
The patients were split into two groups. The first group was given the anesthetic medication sevoflurane plus a narcotic through an IV before entering surgery. The second group was given the anesthetic medication propofol plus a narcotic through an IV before entering surgery.
The researchers tested levels of the three stress response hormones — cortisol, epinephrine and norepinephrine — of each patient before, during and two hours after surgery.
The results of the study showed that having diabetes increased the risk of developing post-surgical delirium by nearly eight times.
The researchers suggested that increases in stress response hormones before and during surgery may have increased the risk of developing post-surgical delirium.
“Peak stress response during anesthesia is highly predictive of [post-surgical delirium], as is the presence of diabetes and surgical duration,” the researchers wrote.
These findings were presented at the ANESTHESIOLOGY 2013 annual meeting in San Francisco, California from October 12-16. This research has not yet been published in a peer-reviewed journal.
No financial information was made available.
