General anaesthesia Q&As
Published by Bupa's health information team, July 2009.
Answers to questions about general anaesthesia
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- Will I be aware of what is happening during my operation?
- What are my chances of memory loss or confusion after general anaesthesia?
- I have heard about a problem called post-operative cognitive dysfunction, what is this?
Will I be aware of what is happening during my operation?
You won't usually be aware of what is happening while under general anaesthesia. Rarely it's possible that you may remember parts of your operation. This is called 'intra-operative awareness'.
Explanation
Being aware of what is happening while under general anaesthesia is rare, it occurs in about one or two out of 1,000 patients. Most people who experience awareness during anaesthesia don't have any pain but remember sounds or the presence of the tube in their throat. Some people may have memories of the recovery room and these are sometimes confused with the operating theatre.
The causes of intra-operative awareness are unknown but some things make it more likely, for example if you:
- use illegal drugs
- have previously had intra-operative awareness
- take high doses of painkillers for chronic pain
Some types of surgery are also more likely to cause intra-operative awareness:
- cardiac surgery
- emergency surgery
- childbirth using caesarean delivery
Your anaesthetist will control your level of anaesthesia by monitoring your heart rate, blood pressure, movement and the amount of tears that you produce. However, sometimes it's impossible to prevent intra-operative awareness.
If you remember anything from your operation, then you should talk to your surgeon or anaesthetist for more advice.
Further information
- Royal College of Anaesthetists
020 7092 1500
www.rcoa.ac.uk
Sources
- Orser BA, Mazer CD, Baker AJ. Awareness during anesthesia. Anesthesiology 2008; 178:185-188. www.anesthesiology.org
- American Society of Anesthesiologists Task Force on Intraoperative Awareness. Practice advisory for intraoperative awareness and brain function monitoring. A report by the American Society of Anesthesiologists Task Force on intraoperative awareness. Anesthesiology 2006; 104:847-864. www.anesthesiology.org
- Risks associated with your anaesthetic section 8: awareness during general anaesthesia. Royal College of Anaesthetists (RCOA), 2006. www.rcoa.ac.uk
What are my chances of memory loss or confusion after general anaesthesia?
Memory loss and confusion after general anaesthesia are common in older people but can happen to people of any age. Most people make a full recovery within a few days.
Explanation
After having a general anaesthetic you may become confused for some time afterwards. Sometimes you may not be able to remember things, such as your name or why you're in hospital. You may behave differently from usual, for example you may be aggressive or anxious.
You're more likely to develop confusion after your general anaesthetic if you:
- have a high alcohol intake
- have a poor memory or dementia
- have difficulty walking
- are generally unwell
Causes of confusion after general anaesthetic that can be treated include:
- infections - you may be given antibiotics
- a lack of pain relief - your pain relief can be increased
- side-effects from pain relief medicines - your medicines can be changed
This confusion can be upsetting for you and for your friends and relatives, but it's important to remember that your doctor, surgeon, anaesthetist and nurses are experienced at dealing with it. Most people who have confusion after general anaesthesia make a full recovery within a few days.
Further information
- Royal College of Anaesthetists
020 7092 1500
www.rcoa.ac.uk
Sources
- Anaesthesia explained. The Royal College of Anaesthetists, 2008. www.rcoa.ac.uk
- Risks associated with your anaesthetic section 7: becoming confused after an operation. Royal College of Anaesthetists (RCOA), 2006. www.rcoa.ac.uk
- Personal communication, Dr Graeme Sanders, FRCA, Spire Alexandra Hospital, 22 January 2009
I have heard about a problem called post-operative cognitive dysfunction, what is this?
Some people over 60 who become confused after a general anaesthetic don't recover fully and this is called post-operative cognitive dysfunction (POCD).
Explanation
POCD is a condition that can affect your memory, concentration and attention. There are two types of POCD - early and late.
Early POCD occurs in the first week after surgery. It affects about one in four people over 60 having heart bypass surgery and one in five people having other types of major surgery. Early POCD may not be severe and it may only be noticed by your close friends or family or by testing for it.
Some people still have a noticeable reduction in their mental ability, such as concentration, three months after surgery. This is called late POCD and may occur in up to one in 20 people over 60 having major surgery. Late POCD may become permanent but it is not known how often this happens.
The exact cause of POCD is unknown but it's more likely if you have heart surgery. There is less risk of early POCD if you have a regional (epidural or spinal) anaesthetic rather than a general anaesthetic.
If you think you may have POCD, talk to your GP for more advice.
Further information
- Royal College of Anaesthetists
020 7092 1500
www.rcoa.ac.uk
Sources
- Bryson GL. Evidence-based clinical update: general anesthesia and the risk of delirium and postoperative cognitive dysfunction. Can J Anesth 2006; 53:669-677. www.cja-jca.org
- Risks associated with your anaesthetic section 7: becoming confused after an operation. Royal College of Anaesthetists (RCOA), 2006. www.rcoa.ac.uk
- Selwood A, Orrell M. Long term cognitive dysfunction in older people after non-cardiac surgery. BMJ 2004; 328:121-122. www.bmj.com
Related topics
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: July 2009
Rate this page
