Expert: Ronald Levy, M.D. - 2/20/2011

Question
Why would you give an 82 year old man Haldol after surgery? He had one third of a lung removed because of cancer there is no sign of cancer anywhere else the surgery was problem free. He was healthy and mentally competent before the surgery now he is confused and does not know where he is. We think it is the Haldol they have him on. Surgery was five days ago and he is still in hospital. I would sincerely like an answer to this question rather quickly because we are planning on telling the Doctor tomorrow to take him off of the Haldol. We cannot get a straight answer from the Doctor as to why he is on this medication.
Thank you,
David S. Driscoll

Answer
I am assuming that what happened was the patient woke up from surgery fine but over the next couple of days became agitated. This is not uncommon in elderly people and is commonly referred to as "sundowning". It is thought to be caused by a disruption in the sleep-wake cycle (particularly in an ICU setting where the lights never go off and the patient is constantly being awakened). Haldol is given to calm these patients down and protect them from themselves and others from them. It is usually weaned off over a couple of days and the patients do fine. I would inquire about this before asking them to discontinue it.


Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston