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Sunday, May 19, 2013
What are the Long Term Effects on the Brain?
I am a 45 yr. old female, had spinal fusion surgery Sept. `05, was in surgery approx. 6 hrs. I had more than what I consider moderate problems with memory and concentration for several months after surgery. I discussed this with my surgeon and he said the effects from the anesthesia should lessen and then disappear within one year. I`m still waiting. I was very concerned about returning to work (I sell modular homes and was the sales manager for my location) due to my inability to think quickly, but particularly because words that I have used all my life now escape me. That seems to be the most glaring effect, I suppose because I know what I want to say, but can`t remember the word that would best communicate my thought. It is very frustrating. I also have some lingering memory issues. I don`t get lost in Wal-Mart anymore, but something is wrong. I know my productivity at work has suffered. Do I need to have an assessment with someone or should I give it more time? I worry about my situation if this gets worse or if I ever need anesthesia again.
Thanks for your question. Your lingering problems with memory and thinking must be a real worry. As I have said elsewhere in this forum, there is some evidence accumulating that seems to implicate general anesthesia in causing problems such as the one you've described, particularly in the elderly (but you are too young to qualify!). The scientific evidence is not very strong and one of the difficulties those studying this phenomenon is that of separating the effects of surgery from the effects of anesthesia. The two go together unless we can find people to undergo surgery without anesthesia, or vice versa. Not likely!
The second possibility is that you have some underlying brain disorder that is not at all related to, but has coincided with, your anesthetic and surgery. Those two theories are not mutually exclusive. It seems that some people with early Alzheimers disease (not that I am suggesting you have this), who have less "reserve" of brain function, will undergo a sharp deterioration after surgery and anesthesia. The hospital experience "unmasks" the underlying condition. The studies suggest that improvement in mental function continues for at least 6 months, maybe longer, so don't lose hope. It is important I believe to "exercise" your brain so don't give up, and try to do things, including reading, that keep you mentally a bit stretched.
If you need another anesthetic in the future, you should obviously mention your concerns to your anesthesiologist. Depending on the surgery it might be possible to avoid general anesthesia and offer you regional anesthesia instead. The studies do not yet clearly show that regional anesthesia is better for the return of cognitive function than general anesthesia but it seems intuitive that there would be less effect.
Another option is for your anesthesiologist to use one of the new brain activity monitors. These allow the anesthetic to be adjusted so that less is used. The final and most important comment, is that NetWellness is not a diagnostic service. If you continue to have problems you should seek attention from your doctor, and possibly a referral to a neurologist.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University