Expert: Ronald Levy, M.D. - 3/17/2008

Question
hello!  I am the wife of a man who has recently begun experiencing memory difficulties after a surgery using general anesthesia.  

On Feb 2 2008 my husband, aged 41 years, went under for what should have been a routine (yet emergency) appendectomy.  Once in surgery, there were multiple complications and he wound up having not only an appendectomy, but also a right hemi-colectomy.  The procedure should have only taken about one and a half hours, but wound up being a little over 3 hours due to the extra procedures involved.  

In any case, he is making his way through the physical recovery process fine, but mentally, he is experiencing significant issues with him short term memory.  He attributes conversations he has had to the wrong individuals (he spoke with my mother on a topic and only a few hours later thought that I had been the one having that conversation with him).  Another example: he was in the shower on Saturday but didn't know why (he was actually getting ready for an evening out for a planned event with friends, but couldn't remember).  He also has that same effect while driving (can't remember why he is in the car or where he is going) and then begins to get flustered.  My husband's job requires quick, thorough, detailed, critical thinking, and he is worried that he will no longer be able to perform his job safely and properly if these memory issues continue.

At the age of 41, and having NEVER had any issues with his memory prior to this surgery, we are concerned that possibly the wrong dosage of anesthesia was used, or the correction dosage for a shorter surgery was possibly used for too long to accomodate the extended surgery time.

We are getting him a CT scan in the meantime, but I thought I would ask if you had any experience with this scenario, or similar ones, that may shed some light on this phenonmenon.

Answer
It has nothing to do with the wrong dose of anesthesia or the length of anesthesia and it likely has nothing to do with anesthesia at all. It sounds like your husband had some pretty major surgery which really saps your energy and can affect multiple organ systems. It will likely resolve but it is a good idea to get the CAT scan to make sure there is no organic reason (e.g. mild stroke, etc).

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston