What does anesthesia do to the mind

Delirium after anesthesia - when the mind disengages

Confusional states after an operation with anesthesia occur again and again in hospital patients. Mostly older people over 65 are affected, who can develop very different forms of neurological impairment, also known as delirium, during their inpatient stay.

The symptoms are often difficult to assign and very diffuse, from slight dizziness and language difficulties to extreme restlessness and aggressive behavior over several days. This is one of the reasons why the dysfunction was often not even diagnosed in the past or was massively underestimated. Recent studies show that around 20 percent of all hospital patients suffer from delirium at least once during their stay, and the number is even higher for those over 65 and children.

There are many reasons for this: In addition to previous surgical interventions or interactions between different drugs, there are a number of other triggers, such as sleep deprivation or acute metabolic disorders. The demarcation is often difficult even for experienced medical professionals. In addition to age, other risk factors for temporary confusion include cardiovascular disorders, alcohol addiction, and metabolic diseases such as diabetes. If those affected then have to undergo anesthesia, the risk of developing delirium increases.

In addition to the fact that patients describe this condition as very frightening in retrospect, more severe manifestations in particular worsen the medical prognosis. Because although only temporarily, they can sometimes cause serious complications that extend the hospital stay and endanger the patient's life. Many suffer serious injuries (e.g. fracture of the femoral neck), for example because they fall out of bed or get up too early. The risk of developing pneumonia also increases in this context.

The good news, however, is that active preventive care and the consistent and early treatment of the first symptoms can prevent or reduce delirium. Therefore, the identification of possible risk patients is of great importance. This can be achieved by carefully collecting the patient's medical history prior to admission to the hospital. Operations that are planned in detail and with the least possible anesthetic load can also effectively prevent the risk. Because modern anesthesia methods such as regional or spinal cord anesthesia in combination with gentle anesthetics are far less stressful for the heart, lungs and brain.

Conclusion: The danger of “delirium” has been recognized and is becoming more and more manageable through consistent strategies and research in this area, so that older and sicker people can go to the hospital with peace of mind.