Is anesthesia generally safe? Or generally risky?
Is it generally true that the older/less healthy you are going in the more likely you are to have a poor outcome?
If someone over the age of 80, with existing cognitive issues needed a knee replacement, would your recommend an epidural as opposed to general anesthesia?
(Opinions welcome, horror stories not particularly appreciated. This is both hypothetical and not, I mean, my mother is the person who would potentially benefit from knee surgery, but it isn’t presently planned. But Dad isn’t much younger . . . )
I think general anesthesia is riskier for older people compared to younger people due to the higher chances of organ failure, but I think it greatly depends on the overall health and vitality of the patient in question..
My mother was hoping to be passed for surgery for spinal stenosis a year before she died. It would help her get up and down from a chair or toilet. But with Covid and other illnesses (for others), that was delayed. She ended up with a UTI, where antibiotics was necessary– meaning no chance of general anesthesia, no spinal surgery for at least six months after antibiotics passed.
I’ve been under anesthesia twice in my life, both times over age 65. Both times I apparently had breathing issues and they had to intubate. Otherwise, no problems that I know of. I take meds for BP and type 2.
My mother had a procedure with a general this morning, she’s 87. This was elective surgery to have Botox injected into her bladder. She was out of the hospital 6 hours after her arrival.
My wife (72) will be getting a knee replacement and shoulder replacement within the next year. Both surgeons said they usually do not use general anesthesia; they use sedation with a nerve block. That surprised me somewhat but I guess it’s not unusual these days for even major surgery to be done without general.
My advice (which seems pretty obvious and therefore probably not very helpful) is to discuss the anesthesia options with the surgeon. It sounds like you haven’t yet reached the point where you’ve even talked to a surgeon? Perhaps the surgeon would be recommending sedation for all their patients anyway. But if you have concerns and would prefer avoiding general anesthesia, it’s likely to be a possible option.
Two unassociated doctors advised us our 85-year old mother would likely survive the general anesthetic but “you won’t be getting the same person back.” Their point was it would have a noticeable deleterious effect in her cognition and mental function.
Before I had back surgery in March (age 77) I went through something called “peri-op” which consisted of medical history, an ecg and blood work. Working with that — and perhaps a Ouija board or Magic 8 Ball — they came up with a 93% chance of no complications.
I have no idea what would have happened if the process produced bad numbers, but in any case the surgery came off fine and there were, indeed, no complications with anesthesia.
The other piece of background for this thread was having dinner with a ninety year old friend who has decided on no more invasive procedures, and was talking about horror stories he’s heard. He was adamant that my mother should not have anesthesia. But he’s not actually making medical decisions for my mother (my dad is still able to handle such things, when Mom can’t).
So I felt like I’d like more information, but I’m a little leery of search engines with respect to medical stuff, so, this is a reasonably broad pool of people who may have applicable experience/opinions.
My Dad had double-bypass heart surgery when he was 83. Obviously he was knocked out for several hours during the procedure, and he recovered from the procedure (and the anesthesia) with no complications. He lived for another 12 years before passing at the age of 95.
General anesthesia in older people can cause progression of dementia, cognitive difficulties, and related physical processes, such that a person might awaken having lost the ability to swallow.
I have seen a couple of people emerge from general anesthesia with obviously reduced cognitive abilities, but they had fairly serious things being mended (like multiple bypass surgery) and it’s possible the underlying condition caused the problem. Still, it manifested immediately after surgery, and not between diagnosis and surgery, fwiw.
I seem to have surgery of one kind or another every couple years or so. The preparatory testing has increased over the years, and doctors have told me the changes are because I’m getting older. For example I think I started getting EKGs before surgery when I passed 50 (though my memory is a little uncertain). There’s another thing at work here, though. Generally there is more medical testing and safety measures just because the field of surgery (and medicine for that matter) is advancing.
I had knee replacement with an epidural and it went fine. I was 68 at the time. I had a hysterectomy with general anesthesia at 72. It mostly went well except I had no desire to eat and in fact could hardly force myself to eat. I was interested to read that sometimes people lost the ability to swallow and wonder if I was having something similar. I had the same loss of appetite two years ago when I had triple bypass open heart surgery at age 77, The heart surgery was the worst recovery as I had NO energy and it took me much longer to recover than I expected. I have been pretty healthy and very active all my life and had a really good recovery from the knee replacement and a pretty normal recovery from the other two surgeries except that they took a lot longer than I expected and I lost a bunch of weight due to the loss of appetite. I do think the fairly lengthy general anesthetic both times was the reason and I would certainly try very hard not to have that again.
Actually I’d prefer no more surgery at all.