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> That said, older people come out of Anaesthesia a bit differently Wow, I hadn’t heard this before, a little scary: “Among patients aged 65 years and older,

> That said, older people come out of Anaesthesia a bit differently Wow, I hadn’t heard this before, a little scary: “Among patients aged 65 years and older, up to 65% experience delirium and 10% develop long-term cognitive decline after noncardiac surgery. “ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8807795 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8807795

ggm 2y ago
I have had limited experience of this, helping seniors with computing problems as a volunteer. One of my mentees had double-hip replacement. He definitely wasn't as sharp afterward. In his eighties. My own cognitive state under anaesthetic, I am told was lucid but entertaining. I was interviewed by a doctor about some research project in wisdom teeth, post operative. It's 30 minutes of my life I have no recollection of, or even awareness. Another time after a colonoscopy I was told I was on a 30 second delay loop, replying well after the normal interval to any question. Slow.
- nicolas_t 2y ago
  Why have general anesthesia for a colonoscopy? It seems that's an unnecessary risk for a procedure that can easily be done without.
  - ggm 2y ago
    It was the classic double of gastro and colon. Rather than a full general I may have been given what is called twilight. Beyond not having intubation, you still don't recall the procedure and afaik it's the same drugs and brain effects. Also if they do find polyps, and burn, or take biopsy I am told it's not exactly easy. They have to move you around. Asleep or dozing may be simpler. You're inflated.
    - nicolas_t 2y ago
      I ask because I've done colonoscopy a few times (I have IBS plus family history of colon cancer) and not once did I get general anesthesia or anything that impacts my brain. It hurts a bit (mostly from the gaz they use to inflate the colon) and yes taking biopsy is a quick sharp pain but it's really not that bad. Likewise for endoscopy (that's significantly more uncomfortable than colonoscopy though). At least in Europe and in Japan, general anesthesia is not part of the sop.
Toutouxc 2y ago
I lost my grandpa (80+) a year ago to suicide. He had surgery for a minor GI issue, then came some complications, another surgery and then another one. He ended up very weak and couldn't walk properly, but his biggest complaint was that his body just didn't feel right after the surgeries. He'd often say that his GI tract felt as if it had been "disconnected," but also that the anaesthesia did something really bad to his head. He'd complain that he was seeing the world "like on a TV screen," as if he wasn't really sitting on the couch with us, living, but just watching things from a distance. Whatever it was, it made life unbearable for him, and he was gone in a few weeks.
- llm_trw 2y ago
  I'm in my 30s and even after mild procedures it takes me months to feel normal again. Medicine has a long way to go before it can deal with the qualia of post treatment life.
- MeImCounting 2y ago
  This is pretty terrifying to me. As someone who messed around a fair bit with altered states in my younger years I can remember feeling very similar to whats described here and being stuck like that is terrifying.
  - drooby 2y ago
    It's called De-realization, De-personalization. Not fun.
    - mistermann 2y ago
      "The psychotic drowns in the same waters in which the mystic swims with delight."
      - bowsamic 2y ago
        Anyone who has trained in a mystic tradition knows that it too feels like drowning, it’s just drowning on purpose, but no less painful and terrifying
krackers 2y ago
Doesn't this imply that there _is_ some sort of damage caused or something, but younger brains are able to work around it easier? General anesthesia should be avoided unless absolutely necessary imo (particularly egregious is doing it for wisdom teeth).

ggm 2y ago

I have had limited experience of this, helping seniors with computing problems as a volunteer. One of my mentees had double-hip replacement. He definitely wasn't as sharp afterward. In his eighties. My own cognitive state under anaesthetic, I am told was lucid but entertaining. I was interviewed by a doctor about some research project in wisdom teeth, post operative. It's 30 minutes of my life I have no recollection of, or even awareness. Another time after a colonoscopy I was told I was on a 30 second delay loop, replying well after the normal interval to any question. Slow.

nicolas_t 2y ago
Why have general anesthesia for a colonoscopy? It seems that's an unnecessary risk for a procedure that can easily be done without.
- ggm 2y ago
  It was the classic double of gastro and colon. Rather than a full general I may have been given what is called twilight. Beyond not having intubation, you still don't recall the procedure and afaik it's the same drugs and brain effects. Also if they do find polyps, and burn, or take biopsy I am told it's not exactly easy. They have to move you around. Asleep or dozing may be simpler. You're inflated.
  - nicolas_t 2y ago
    I ask because I've done colonoscopy a few times (I have IBS plus family history of colon cancer) and not once did I get general anesthesia or anything that impacts my brain. It hurts a bit (mostly from the gaz they use to inflate the colon) and yes taking biopsy is a quick sharp pain but it's really not that bad. Likewise for endoscopy (that's significantly more uncomfortable than colonoscopy though). At least in Europe and in Japan, general anesthesia is not part of the sop.

Toutouxc 2y ago

I lost my grandpa (80+) a year ago to suicide. He had surgery for a minor GI issue, then came some complications, another surgery and then another one. He ended up very weak and couldn't walk properly, but his biggest complaint was that his body just didn't feel right after the surgeries. He'd often say that his GI tract felt as if it had been "disconnected," but also that the anaesthesia did something really bad to his head. He'd complain that he was seeing the world "like on a TV screen," as if he wasn't really sitting on the couch with us, living, but just watching things from a distance. Whatever it was, it made life unbearable for him, and he was gone in a few weeks.

llm_trw 2y ago
I'm in my 30s and even after mild procedures it takes me months to feel normal again. Medicine has a long way to go before it can deal with the qualia of post treatment life.
MeImCounting 2y ago
This is pretty terrifying to me. As someone who messed around a fair bit with altered states in my younger years I can remember feeling very similar to whats described here and being stuck like that is terrifying.
- drooby 2y ago
  It's called De-realization, De-personalization. Not fun.
  - mistermann 2y ago
    "The psychotic drowns in the same waters in which the mystic swims with delight."
    - bowsamic 2y ago
      Anyone who has trained in a mystic tradition knows that it too feels like drowning, it’s just drowning on purpose, but no less painful and terrifying

krackers 2y ago

Doesn't this imply that there _is_ some sort of damage caused or something, but younger brains are able to work around it easier? General anesthesia should be avoided unless absolutely necessary imo (particularly egregious is doing it for wisdom teeth).