Are you shocked over how delirious your elderly mother (or father) is after surgery—such as a hip replacement, knee replacement or coronary bypass?
It’s called postoperative delirium, and about half of elderly patients experience this—and it’s linked to the general anesthesia.
My mother at age 88 underwent a hip replacement, and the delirium after the surgery was significant.
You’ll know it when you observe it; it’s not subtle.
For instance, while in the hospital bed, she thought she was at home and that a nearby table was her kitchen desk.
Why an Elderly Patient Develops Postoperative Delirium
A news release came out in August 2015 by the Department of Geriatrics and Gerontology at the Rowan University School of Osteopathic Medicine.
The researchers tested Sevoflurane and Isoflurane, anesthetics that are inhaled during surgery, on animal models. Sevoflurane disrupted the blood-brain barrier, while Isoflurane didn’t.
The study’s lead author, Nimish K. Acharya, PhD, explains in the report that when the blood-brain barrier is disrupted, “various plasma components gain access into the brain” and bind to some neurons, possibly disrupting “normal neuronal activity.”
Dr. Acharya adds that this may “cause the onset of symptoms that define postoperative delirium.”
When I asked nurses and doctors why my elderly mother was so delirious, their standard reply was, “It’s the anesthesia.”
I thought this was just one of those quick, ambiguous responses to a hovering family member, but there was definitely some truth behind this response.
So why are patients who suffer from delirium right after surgery elderly rather than 30-something?
The study’s older animals showed a big increase in the “density and extent of vascular leak” in their cerebral cortexes from the Sevoflurane, says the report.
Robert Nagele, PhD, the study’s corresponding author, explains that a less potent anesthetic for elderly patients should cause less disruption to the blood-brain barrier.
If your elderly mother or other relative is still delirious days after their surgery, don’t panic.
My mother fully recovered from her cognitive impairment, though this didn’t happen overnight. It tapered off. Each patient is different.
