Surgery, Anesthesia and Memory Loss

Summary:  After surgery, many people experience short-term delirium and/or longer-term cognitive decline.  Scientists are still studying how to prevent these problems.

Doctors, families and patients report that surgery seems to cause short-term delirium and/or longer term memory loss in some people.

In a recent Duke University study of 1064 patients undergoing major surgery (but not heart surgery), neuropsychological tests showed the following rates of post-operative cognitive dysfunction or POCD:

Age range                  Leaving hospital      3 Months After Surgery

18-39 year olds                 37%                                 6%     

40-59 year olds                 30%                                 6%

60 or older                         41%                               13%

Zhongcong Xie, M.D., Ph.D.

Even higher rates of POCD have been reported after heart surgery, but scientists still don't agree on how to measure these problems, or on whether the heart patients also had memory loss before their surgeries.

Dr. Zhongcong Xie, Assistant Professor at Massachusetts General Hospital and Harvard Medical School, is working with his colleagues to determine what causes POCD.

POCD seems to be worse among the elderly, but "the reason why age is a risk factor for POCD remains to be determined," Dr. Xie says.  In his lab, he and his colleagues are researching

possible additional risk factors, including:

• Isoflurane, an anesthetic
• Desflurane, an anesthetic, combined with low levels of oxygen during surgery
• Low levels of carbon dioxide during surgery.

Other researchers are examining whether low body temperature during surgery or inflammation could be to blame.

So, if you need surgery, are there any steps you can take to lower your risk of delirium or POCD?  Unfortunately, until there are more human studies, we just don't know.  "The findings in all of the studies in this area are important," says Dr. Xie.  "But I would advise caution in extrapolating these findings in test tubes and in animals to humans.  Much more research needs to be done before we can come to any conclusions."

Comments

[Gail Rae Hudson]

I've had a fear of this, on behalf of my mother, for some time. So far she's been lucky in not requiring surgery that needs general anesthetic. I suppose, at this point, being on Hospice and all, she won't be getting any surgeries. I can report that the last surgery my mother had that involved a general anesthetic was in 1973. It was a routine D&C that used to be done to women who were in that latter stages of menopause. Maybe one of the precautions people should take is investigating, prior to any surgery that isn't absolutely necessary, whether the possible risks are worth the benefits. In my mother's case I doubt that this particular surgery, which would be considered unnecessary now, did her any harm. At least, for many years harm didn't seem to be indicated. But, probably, at this point, the best approach would be, the less surgery, the better.

[Len Wheeler]

I recently had surgery on my knee - arthroscopic. I was only to be in 45 minutes but was in 90 minutes. Things were complicated after and there was major bleeding and swelling to my leg. I had to keep it elevated to avoid a DVT and Pulmonary embolism.

Since surgery my lady-friend has told me I forget things very often and can't remember conversations from the morning. I had a frontal lobe brain injury 12 years ago from a head-on car crash and was at the Brain Injury Clinic. Unfortunatly I went from patient to care giver when my wife got into a major accident and became an invalid. She eventually died, but I had no more treatments at the clinic.

I don't know if this is related to medication the hospital gave me and my worry is that I may have had a TIA.

Appreciate your opinion

[Mona Johnson]

Len,

I'm sorry to hear of your head injury, your wife's death and your knee surgery.

It sounds like your situation is complicated, and you might benefit from a visit to a memory disorder clinic or neurologist who can sort out what's going on.

I'm not sure where you live, but if there's an Alzheimer's Disease Research Center you can get to, that might be a good place to start. The National Institute on Aging has a list of these ADRCs at http://www.nia.nih.gov/Alzheimers/ResearchInformation/ResearchCenters/.

Take care and good luck,

Mona

[Jason Butler]

I have had over twenty surgeries the past four years, starting when I was nineteen until now, being 23. I had surgery for Ulcerative Colitis back in August of 2004, and numerous other ones to try and fix pelvic sepsis that developed from a j-pouch that was constructed then. I had my last surgery 9/17/08 where they gave me a permanent illeostomy. None of the other pouches worked. I find I have lost a lot of memories, people will reminisce to me about things we'd done and I simply can not recall the events. Some I can, but they're very vague. That's not to say I've lost all memories, by any means. I also find my cognitive abilities have decreased as well. I don't use any street drugs or drink alcohol. My doctors say it has nothing to do with the anesthesia, but I beg to differ. Could you please let me know if you think my reasoning holds any validity, or explain what you think might be going on, or refer me to someone who can? On a side note, if you need a research subject, I'm willing to be one! I appreciate your time and concern with this possible amnesic case of mine.

-Jason Butler

[Mona Johnson]

Jason,

Thanks for your interesting comment. I'm sorry to hear about your illness and surgeries!

I'm neither a scientist nor a doctor, so I'm not qualified to give you an opinion on your case. You might try to locate a memory clinic or Alzheimer's Disease Research Center (see above comment) near you to get an opinion. You might also search using PubMed (http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed)to see who is published in this area.

There are a number of studies going on about this potential problem - see http://www.clinicaltrials.gov/ct2/results?term=anesthesia+cognitive for a list. At least in most cases, I think you have to be undergoing certain kinds of surgery to participate in a trial, so that's not very attractive.

Good luck!

Mona

[Myra]

I am 46 years old and had gallbladder surgery Aug of 2007. I’ve had Memory loss ever since. It has become slowly better, but some days I have a hard time having a conversation because I cannot remember words. I was offered a great job last spring that before the surgery I could have done in my sleep, But I knew I could not do it now. I am wondering how long this will go on for.

[Mona Johnson]

Myra,

I'm sorry to hear about your surgery and your memory loss. Have you talked to your doctor or made an appointment at a memory clinic to get to the bottom of this? You might have other health issues that contribute to your problem.

I hope you get better soon!

[michelle]

my name is michelle. im 16 yrs old and i just had surgery dec. 2nd. i have short-term memory loss and drs dont know if its permanent or temporary.

[Bev Fritz]

My mother had surgery a week ago and went into A-Fib in the recovery room. She was fine in recovery and that evening. The next morning her speech became slurred and she lost much memory - there was no evidence of stroke.
We were told this is common for elderly.

[Evoulla]

My Grandad is 80, and has gone in for a knee operation 4 days ago. To this day he has memory loss, very dis orientated and confused.

Is this normal & How long will this last for?

We are hoping that the drugs, anesthetic is causing this?!

It is very worrying for us all, as he was a fit and healthy man before the op, and now he is like this!!!