Side Effect #: Itching
A curious side effect of narcotic pain medication is itching. Most people complain of itching on their face, especially the tip of the nose. Sometimes, people will have significant, all-over body itching and believe they are having an allergic reactionand it can be hard to tell the differencebut most of the time, it’s just a side effect.
Luckily, Benadryl can easily treat this side effect. However, first make sure it’s okay to take over-the-counter medicines with the prescriptions you have been given. In the hospital, patients can get a special medicine that block the receptor responsible for itching but not pain relief, which is even more effective.
Narcotics are routinely used during anesthetics to block pain receptors and often cannot be avoided. Tell you anesthesia provider if you have had this bothersome side effect in the past.
The Effects Of Anesthetic Agents On Pocd
Several studies have also been designed to assess whether the risk of POCD differs with general anesthesia using inhalational agents, vs. GA with TIVA . A recent meta-analysis combined data from seven studies, and concluded that TIVA may reduce the risk of POCD, with an odds ratio of 0.52; however, this certainty of this conclusion is low due to heterogeneity of diagnostic tools utilized, variability in time of assessment, and inconsistent data reporting . Furthermore, the authors reported that there were 11 ongoing studies on the topic at the time of the meta-analysis in 2018. At this time, it would be premature to conclude superiority of one mode of anesthetic.
Limited available data also demonstrates mixed results regarding the impact of other modifiable factors on POCD risk including hypothermia and pre-operative and intraoperative glycemic control . Further prospective RCT evidence is required to evaluate the contribution of these factors to delayed neurocognitive recovery.
Consent: Individuals over the age of 65 should be informed of the risk of postoperative delirium and perioperative neurocognitive disorder prior to their procedure;
Baseline cognitive assessment: Cognitive function should be assessed preoperatively using a brief screening tool. Examples of screening tools provided included the Minicog, MoCA, MMSE, clock-drawing test, verbal fluency test, or the cognitive disorder examination;
Get Back Into Good Sleep Habits
After a procedure, you can combat the disruption to your body clock by practising good sleep hygiene. This involves maximising cues to the body that it is time to sleep in the evening. These could include avoiding stimulants like caffeine and alcohol, going to bed at a similar time each night, being in a dimly lit room and engaging in calming or restful activities before sleep, like reading.
Making sure you are exposed to bright sunshine during the day and avoiding back-lit screens on technology devices in the evening can also help.
Lingering grogginess after general anaesthesia is hardly ever sinister. But if it is persistent, getting worse rather than better, or is associated with confusion, weakness or numbness, then you must see your doctor.
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What If Side Effects Bother Me
If you have any concerns about side effects after undergoing a dental anesthesia procedure, reach out to your dental professional right away. It’s vital to take an active role in your dental care, especially when it comes to surgery, and we encourage you to do so.
Dentists treat millions of patients with anesthesia safely every year. Your dental professional will guide you in what anesthesia is best for your procedure. It’s essential to understand your dental treatment’s risks and benefits and always let your dental team know if side effects come up. The key is that you and your dental professional work together so that you can stay comfortable, healthy, and smiley.
Anaesthesia And Long Term Memory Effects
It isnt uncommon for people to observe elderly surgical patients experiencing confusion after their operation. These symptoms usually fade with time.
However, in recent years, more research has been pointing to something a little more serioussomething called postoperative cognitive dysfunction . POCD involves problems with memory, attention, and concentration that can last months or sometimes even a lifetime.
Why is this concerning? Well, a 2008 study showed that people who still had POCD 3 months;after surgery were more likely to die in thefirst year after;
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Drug Could Be Useful Treatment For Anesthesia
Experimental Receptor Blocker Shows Promise in Treating Cognitive Deficits after Anesthetics
Newswise San Francisco, CA. A drug targeting one specific receptor may provide the first effective approach to treatment for the common problem of memory loss after surgery and anesthesia, according to an experimental study in the April issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society .
The “proof-of-concept” study shows that alpha-5 GABA type A receptors play an essential role in the development of specific memory problems after anesthesia, “and that these receptors can be targeted to restore memory even after the anesthetic has been eliminated.” The lead author was Agneiska A. Zurek, BSc, of University of Toronto.
Anesthesia-Related Memory Loss Linked to Specific ReceptorsThe researchers performed a series of experiments in mice to assess the mechanisms of memory loss after general anesthesia. The study focused on the alpha-5 GABA type A receptors, which are the principal target for most anesthetics.
Previous studies had also suggested that these receptors play a role in certain types of anesthesia-related memory impairment. The experiments included genetically engineered mice that lacked the alpha-5 GABA type A receptors. Behavioral tests were used to assess specific types of memory function.
Excess Inflammation May Trigger Cognitive Decline
Surgeries in elderly patients are becoming more common, and cognitive impairment is increasingly acknowledged by anesthesiologists to be a common side effect of surgery in these patients. A few studies in recent years have found that upwards of 10 percent of surgery patients ages 60 and older show some degree of cognitive impairment three months following surgery, although the diagnostic criteria for the condition have not yet been standardized, and causes and risk factors are still being explored.
Post-operative cognitive dysfunction was previously believed to be caused by deep anesthesia during surgery. But increasing evidence instead links the condition to an inflammatory reaction in the brain, now understood to be a normal response to tissue trauma occurring anywhere in the body ;even surgeries physically distant from the brain, such as hip replacement, may trigger this response. Studies have shown that when this inflammation is excessive or too persistent, as may be the case in the elderly, the normally protective response can negatively impact cognition.
Previous studies on post-operative inflammation in the brain had focused on whether circulating immune cells invade the brain and contribute to cognitive decline, Koliwad said. Based on our new research, we now know that the brains own microglia initiate and orchestrate this response, including the infiltration of peripheral immune cells and the resultant memory loss.
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Post Operative Cognitive Decline
There are many reports of seniors who had a surgical operation and after it experienced memory loss, trouble with multi-tasking, difficulty in learning new skills, inability to concentrate and other cognitive problems. This is called postoperative cognitive decline which is usually temporary, but in some cases it remains the same and in others it can progress until it becomes full-blown dementia.;The onset of dementia may be in the weeks, months or even years after the operation.;There are also reports of seniors who develop delirium, especially after heart surgery.
However, few seniors are warned about the risk for POCD before they undergo surgical operations. While surgery may be necessary and life-saving,; seniors are not always told that many operations can also be carried out by using local anesthesia rather than general anesthesia. Local anesthesia deadens pain, but allows a person to remain awake during the surgery and they do not need to go to a recovery room after the operation. General anesthesia is sometimes accompanied by serious complications in the elderly. Seniors must ask their surgeons exactly what risks they face with the operation and if the operation can be done with local rather than general anesthesia.
Anesthesia Linked To Increased Dementia Risk In Seniors
Exposure to anesthesia has been linked to a 35 percent increase of dementia in patients over age 65, according to a new study.
FRIDAY, May 31, 2013 Caregivers and seniors struggling with the dilemmas of elder care have another risk to weigh against potential rewards senior patients exposed to general anesthesia face an increased risk of dementia, according to research presented at Euroanaesthesia, the annual congress of the European Society of Anaesthesiology .
Researchers reviewed the medical information of 9,294 French patients over the age of 65. The patients were interviewed several times over a ten year period to determine their cognitive status.
After two years, 33 percent of participants had been exposed to anesthesia. Most of the;exposed patients were exposed to general anesthesia a medically induced coma. The rest were exposed to local/locoregional; any technique to relieve pain in the body anesthesia.
In total, 632 participants developed dementia eight years after the study began. A majority of these patients, 512, were diagnosed with probable or possible Alzheimers disease. The remainder had non-Alzheimers dementia.
The gap between dementia related to general anesthesia and non-dementia patients was associated with a 35 percent increased risk of developing dementia. This risk was linked to at least one general anesthesia.
Researchers hope this study will lead to more awareness for surgeons.
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Cognitive Decline After Surgery Tied To Brains Own Immune Cells
In Mouse Study, Experimental Drug Blocks Post-Operative Memory Loss
After undergoing surgery, elderly patients often experience cloudy thinking that can last for weeks or even months. At one time researchers thought this cognitive decline might be caused by anesthesia, but mounting evidence suggests that heightened inflammation in the brain following surgery is the more likely cause.
Now a new study in mice by UC San Francisco researchers suggests that brain inflammation and cognitive decline following surgery are triggered by the brains own specialized immune cells, called microglia. Mice given an experimental oral drug that temporarily depletes microglia ahead of an operation were much less likely to fail memory tests several days after surgery, the UCSF team found, suggesting a possible new approach to preventing the condition in humans.
The study, published April 6 in JCI Insight, an online, open-access companion publication to the Journal of Clinical Investigation, was led by collaborators Suneil Koliwad, MD, PhD, assistant professor of medicine, and Mervyn Maze, MD, professor of anesthesia and perioperative care at UCSF. Koliwad has been studying microglia for several years, and Maze developed the mouse model that was used to investigate cognitive effects of surgery.
Evaluating Memory Dysfunction After Spinal Anesthesia Among Patients Undergoing Elective Surgery: Descriptive
Anesthesia has a number of side effects including cognitive impairment after the surgery.
Postoperative cognitive impairment is commonly associated with general anesthesia.
It can be concluded that spinal anesthesia had a significant effect on logical memory.
-Age and blood pressure was significantly associated with changes in memory.
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General Anesthesia Side Effects And Complications
As a board-certified anesthesiologist, Ive walked hundreds, if not thousands, of patients through the process of anesthesia, explaining to them how it works and what the possible side effects and complications might be. In this article, I will share with you what I tell my patients. Ill give you the rundown on what to expect and how to prevent some potentially unpleasant after-effects.
Before going on, though, it might be helpful to distinguish a “side effect” from a “complication.” A side effect is an annoying and perhaps unpleasant outcome that accompanies the desired effect of a treatment. However, side effects typically do not cause any lasting harm. For instance, weight gain is a side effect of certain medications. Once you go off the medication, however, the weight gain typically goes away.
A complication, on the other hand, is an undesirable outcome of a treatment that causes harm to the patient. Complications are sometimes avoidable and sometimes not, depending on any pre-existing conditions and other factors.
Although the safety record is remarkable, side effects often cannot be avoided. Most people experience one or more of the most common anesthesia side effects.
General anesthesia has side effects and risks, but it is a necessity for many operations. Discuss your specific risks with your surgeon and anesthesiologist.
When Is Anesthesia Needed
Although routine trips to the dentist usually involve a simple yearly dental hygiene appointment, sometimes more work is needed to keep your teeth healthy. Some common procedures that typically require anesthesia include tooth extractions, wisdom teeth removal, root canals, and filling cavities. Out of all of these instances filling cavities is the most common use of dental anesthesia.
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General Anesthesia Or Surgical Trauma
Several studies have been carried out to try to determine if the cause of this postoperative cognitive decline is from the general anesthesia or from the trauma of the surgery. Some studies show that the surgery itself causes inflammation in the body which can cross the brain barrier and spread to the brain and damage the brain. Other studies show that the general anesthesia which puts patients into a coma-like state may be responsible for making changes in the brain, especially in seniors who may already be genetically likely to develop dementia. Some animal studies show an increased rate for developing Alzheimers disease after surgery with general anesthesia, but more research is necessary to form positive conclusions concerning humans.
If research proves the general anesthesia is responsible for POCD, seniors can explore the possibility of doing the surgery under local rather than general anesthesia. General anesthesia also carries a higher risk for other complications in the elderly like pneumonia.
The Connection Between Anesthesia Delirium And Dementia
When examining the potential cognitive effects of general anesthesia on older adults, it is important to first make the distinction between two commonly confused conditions: delirium and dementia.
While these ailments share similar symptoms, such as confusion, problems with perception, mood swings and decreased cognition, there are crucial differences between them. Delirium refers to abrupt, temporary changes in a persons mental functioning, whereas dementia describes a more gradual, permanent decline in cognitive abilities caused by chemical and/or anatomical changes in the brain. People with dementia can exhibit signs of delirium, but the two terms are not interchangeable.
Postoperative delirium is a common cognitive after-effect of general anesthesia, particularly for the elderly. The American Society of Anesthesiologists explains that confusion, difficulty focusing and memory issues associated with postoperative delirium can come and go and usually disappear after about a week.
Postoperative cognitive dysfunction is a more severe condition that may affect seniors who have received monitored sedation or general anesthesia. POCD is characterized by marked changes in cognition and both short- and long-term memory that can persist for weeks or months after a significant surgery. According to the ASA, the following chronic conditions can increase a seniors risk for POCD:
- Heart disease
- Lung disease
- Parkinsons disease
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Is There Any Evidence Of Anaesthesia Causing Memory Loss
Lets look a little more into the phenomenon known as post operative cognitive dysfunction , as its a condition that has been researched closely.
Most of these POCD studies have focused on the elderly, because thats where this phenomenon is most commonly seen.
A 2001 paper in The New England Journal of Medicine kept track of patients who received coronary artery bypass surgery using a specific method where a heart-lung machine circulates and oxygenates the blood. The researchers found that many patients complained that they had a mental haziness after the surgery. According to the paper authors, more than half of the patients left the hospital with signs of cognitive decline and 42% were still impaired 5 years later.
Though critics were unsure whether the data was accurate, later studies revealed that the patients still developed cognitive difficulties at about the same rate whether they had pump or “off pump” surgery.
Other studies have reached different conclusions. For example, in February 2016, an anesthesiologist named Juraj Sprung of the Mayo Clinic and a team looked at the prevalence of mild cognitive impairment . MCI is essentially a mental downturn that often is a precursor to Alzheimer’s disease. The team compared how often MCI appeared in people who had undergone an operation or procedure that required general anaesthetic since the age of 40 against how often it appeared in people who had not. They did not find a link.
Why Versed Is Used
Versed is typically used for:
- Sedation during procedures that don’t require general anesthesia;but do require you to remain calm and relaxed, such as a colonoscopy
- Sedation after surgery
- To help keep people in intensive care calm while on a ventilator
Versed can be used in combination with pain medications or other types of sedation. While it is commonly combined with Fentanyl, a powerful pain medication, it can also be combined with Propofol and other medications.
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Anesthesia In Individuals With Cognitive Impairment
Alzheimers disease accounts for the majority of cases of dementia . AD is a fatal progressive neurodegenerative disorder, characterized by neuronal degeneration in the basal forebrain, entorhinal cortex, hippocampus, and cortex . Pathological hallmarks include the presence of senile plaques which contain Amyloid- , and neurofibrillary tangles which form in the presence of pathological modifications to the microtubule-associated protein, tau. The pathways underlying neurodegeneration are complex and involve many players including soluble and insoluble A, hyperphosphorylated tau, neuroinflammation and microglia dysfunction, cholinergic deficits, and oxidative stress .
AD and other forms of dementia can impact the ability of anesthesiologists to collect a detailed history and elicit appropriate cooperation for physical examination. The potential for confusion and limited cooperation may make approaches such as neuraxial anesthesia, peripheral nerve blocks, or sedation more challenging. In terms of pharmacologic management, it is commonly accepted that short-acting medications should be used, and medications which may increase risk of postoperative confusion should be avoided . Available evidence does not support the hypothesis that these patients are more sensitive to anesthetic agents; however, the sample size employed in these studies and use of the BIS monitor as a surrogate of anesthetic depth make it challenging to draw any definitive conclusion .