Expert: Ronald Levy, M.D. - 6/11/2008

Question
My 82 year old husband had a TKA last November using a general anesthesia. After recovery, he seemed fine, but during the night he became confused & tried to get out of bed.  Since then he has been quite irritable, and has noticeable memory lapses, which he did not have before.

Answer
This is not unusual for someone that age who has undergone a major surgical procedure. The condition is not related to the anesthesia per se, but is exacerbated by it. Often this is due to a condition sometimes referred to as "sundowning". Because you never get good sleep in a hospital, the sleep deprivation starts causing confusion, acting out, etc. You need to make sure that there is no underlying organic reason for the problem (stroke, etc), and these effects are usually self-limiting.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston