Duration of side effects
How long the side effects last after anesthesia varies from patient to patient. While some do not complain about side effects at all, others suffer from nausea and vomiting. In addition, the duration of the side effects is related to the duration of the surgery.
The longer the anesthesia lasts, the longer and more pronounced the side effects can be. The most common side effects after surgery are nausea and vomiting. These occur after about 30% of general anesthesia.
Since special medications, the so-called antiemetics, can be given to relieve nausea if symptoms occur after the operation, they usually go away quite quickly. Untreated, it lasts about 2-3 hours. It is possible that the voice is a bit rough after the operation and the neck hurts.
This is due to the breathing tube that is in the windpipe during the operation. The sensation may persist for up to a few days after the anesthesia. The dazed feeling that most patients experience after general anesthesia lasts for varying lengths of time. Therefore, it is important not to actively participate in traffic 24 hours after the operation and to take care of yourself.
Typical side effects of anesthesia
Nausea, together with vomiting, is one of the most common side effects of anesthesia. In medical terminology, this is known as postoperative nausea and vomiting (PONV “postoperative nausea and vomiting”). Both nausea and vomiting are protective reflexes of the body, which are intended to prevent toxic substances from entering the body.
The body recognizes the drugs used for anesthesia as harmful to the body and therefore tries to eliminate them. With general anesthesia, the risk of suffering from nausea and vomiting after the operation is about 30%. However, nausea can also occur afterwards with local anesthesia.
However, the risk here is only about 10%. Therefore, depending on the type of surgery, it is possible to reduce the risk of postoperative nausea by using local or spinal cord anaesthesia.Due to various factors the risk can increase considerably. These risk groups include women, non-smokers, the suffering from motion sickness and patients who have undergone a long operation and therefore a long anaesthetic.
In addition, the nausea depends on the choice of the anaesthetic drug (anaesthetic). If inhalation anaesthetics are used during anaesthesia, nausea is more common afterwards. Many clinics and doctors therefore try to keep the use of gases as low as possible and resort to other drugs.
Usually the nausea subsides by itself after a few hours. However, there are also medications (antiemetics) that work against the nausea and can be administered after the operation. If there is an increased risk, these drugs can also be given prophylactically during the operation.
Nausea and vomiting after an operation is not uncommon, but in most cases it is harmless and only of short duration. Rarely, however, complications can occur and there may be respiratory problems with lack of oxygen or tearing of the esophagus. Anaesthesia particularly affects the processes in the human brain.
Due to its complexity, the occurrence of confusion after anaesthesia is not uncommon. Immediately after waking up, confusion is initially completely normal after every anaesthetic. Even if the patient is already awake and shows initial reactions, there is still a certain amount of anaesthetic in the body and this affects consciousness.
This is how disorientation and confusion can occur during the waking phase. After minutes or half an hour, the condition returns to normal. In addition to this confusion that occurs in the wake-up phase, there are also states in which consciousness is restricted more clearly and for longer periods of time.
Although this is more likely to occur in older patients, young patients may also be affected. If increasing confusion occurs hours or a few days after anesthesia and lasts longer, the physician speaks of postoperative delirium. It manifests itself in difficulties to orientate oneself in time or place.
The affected person does not know where he is or what day it is today. Memory can also be impaired to varying degrees, ranging from short memory gaps to not recognizing relatives. The alertness and activity of those suffering from this form of confusion are divided into two forms, a hypoactive and a hyperactive form.
While the hypoactive form is more common and is characterized by intimacy and difficult responsiveness, the rare hyperactive form is characterized by a pronounced restlessness that can extend to bed-riddenness. These side effects disappear again a few days after the first appearance. Friends and relatives can speed up the healing process with familiar surroundings and stories.
In individual cases, similar symptoms do not appear promptly after anaesthesia, but only after weeks and more severely. This side effect of anesthesia is called postoperative cognitive dysfunction. It is accompanied by severe confusion and impairment of almost all cognitive functions, such as concentration, memory and attention.
The risk of this disorder increases with the extent and duration of the operation and thus the anaesthesia. However, this side effect is also reversible and usually goes away on its own. Overall, it can be said that confusion in various forms is a common side effect of anesthesia, but it almost never requires special treatment and returns to normal spontaneously within days.
Headaches are a possible side effect of anesthesia. They typically occur in regional procedures close to the spinal cord, such as epidural anaesthesia, but can also occur under general anaesthesia. Older patients in particular suffer from headaches after anaesthesia, which is aggravated by possible accompanying diseases.
Long procedures and complicated operations also increase the risk of headaches. Some agents such as the frequently used Propofol can cause headaches in the wake-up phase as a possible side effect, but these are not long-lasting and disappear by themselves. The influence of medication is only one possible cause.
Headaches are usually not known to be a frequent side effect of the drugs used, but rather the cause of processes during anesthesia. Of course, operations on the head always involve the danger of this side effect, which cannot be prevented.In some operations, the head must be placed deep so that the head is the deepest point of the body during the entire period of anesthesia. The blood follows gravity, which can cause headaches after waking up.
Another cause of headaches after anesthesia is an imbalance in the body. For example, a slight loss of blood or water during the procedure that has not yet been balanced can cause headaches. Infusions can help quickly.
It is possible that electrolytes, i.e. salts such as sodium and potassium, are returned to the body with the fluid if these concentrations are no longer correct. If the headache does not go away on its own after a certain period of time, it is possible to suppress the pain with additional painkillers such as ibuprofen. A risk group for the occurrence of headaches are patients with migraine.
They often suffer from this side effect, but can also be treated accordingly. In summary, headaches after anaesthesia can occur as a side effect especially with the appropriate procedure – low position of the head, long operation – but overall they are a rare side effect and are usually well treatable. They often occur during regional anaesthesia procedures.
Especially mothers of still young children often report to the clinic because their child suffers from diarrhea after an operation under anesthesia. In such cases, it is rarely possible to find out the actual cause by talking to a doctor. But what could be the reason?
First of all, diarrhoea is not one of the usual side effects of anesthesia. The drugs used do not attack the intestines and therefore cannot cause diarrhoea. Actually more frequent postoperative side effects are nausea and vomiting, as well as nightly restlessness and rarely also perception disorders.
However, all these symptoms usually disappear without a trace over time and do not leave any late effects. Nevertheless, many patients now ask themselves the question: Where does my diarrhea come from? An operation is often a difficult stressful situation for many patients.
The fear of pain, the long recovery time and other unpleasant side effects of an operation are perceived very differently by patients. Anxious people in particular tend to experience increased stress, which can ultimately manifest itself in a nervous bowel and thus cause diarrhea. Especially children, who do not really understand operations and cannot imagine themselves under anesthesia, are often frightened and overstrained after an operation.
For this reason, they often suffer from postoperative diarrhea. In rare cases, an intolerance to the medication used may be the cause. But how should a mother deal with the situation?
Since the diarrhea usually has no medical cause, going to the doctor is often unnecessary. However, if the operation has been performed on the intestine and the diarrhoea lasts for several days and is associated with pain, a doctor should always be consulted. Possible cause could be an inflammation in the intestine, which was caused by the operation but not by the anesthesia.
Otherwise, the patients should take it easy and stay in bed. It is also important to compensate for the loss of fluid. Since the body can lose up to 5 liters of fluid during diarrhea, the affected person should always drink a lot.
Suitable are mild teas such as camomile tea, but also cola or simply water. Dry foods such as salt sticks or rusks are suitable as solid food. Hair loss is similar to diarrhoea after anesthesia.
Because here again, it is not the drugs of the anesthesia that are to blame. The anaesthesia itself is a great strain on the body. In addition with the psychological component, a strong stress situation results for the patient.
As is generally known, long lasting stress can lead to slight hair loss. Therefore, in rare cases, patients suffer from hair loss, but this is not due to the medication, but to the stressful, physical strain. In addition, it is being discussed whether a slackening of the cells in the hair root can perhaps be a trigger for hair loss.
The anesthesia puts the body into a kind of deep sleep, in which all muscles are relaxed. In addition, the metabolism is shut down and the cells work less.If this also applies to the cells of the hair root, which are responsible for anchoring the hair shaft in the scalp, they can no longer fix the hair strongly enough and it falls out. However, it must be emphasized that this is only an unproven theory that should not be believed blindly.
In rare cases, patients complain of restlessness and insomnia after general anesthesia. This can be a real burden, as patients should rest after an anaesthetic. After all, anesthesia is a great strain on the whole body.
But where does the restlessness come from? It is safe to say that it is not caused by the drugs used in general anesthesia. They have rather the opposite effect: they slow down the metabolism and make the patient feel tired.
Is the restlessness therefore only a fantasy? Yes and no. Every person experiences an anesthesia differently.
Since it is often associated with major surgery, many patients are anxious. In addition, there is the feeling of defenselessness during a deep sleep. All this can be very stressful.
Anyone who has stress becomes restless. Therefore, people with a thin nervous system are more likely to suffer from this restlessness. If this is the case, the doctor can prescribe a light sedative to help patients relax after an anaesthetic.
Often distraction can also help, for example through forgetfulness, confusion, disorientation and cognitive dysfunctions can be observed in rare cases in patients after an anaesthetic. These symptoms occur particularly frequently in older men, some of whom are already cognitively impaired (e.g. due to dementia) or have other illnesses such as high blood pressure or diabetes. General anesthesia is suspected of exacerbating degenerative brain diseases such as Alzheimer’s disease.
It is noticeable that forgetfulness occurs mainly after unplanned operations. In addition, bone fractures caused by falls or major emergency heart surgery can also occur. The actual cause of these symptoms is not yet fully understood.
Small inflammations in the brain are suspected, which occur during the operation and damage it. How does the doctor recognize forgetfulness after anesthesia? Quite simply by asking questions.
For example, after the operation the patient should know his or her name, date and location. He should also be able to recognize his relatives and be able to answer further questions. Patients are often befogged after an anesthesia and are not able to formulate clear sentences.
In most cases, however, these symptoms subside within a few hours after the operation. Real damage to the eye, which occurs after general anesthesia and can be directly associated with it, is unknown. Often the patient feels a black eye after an operation, but this is not due to damage to the eye.
This loss of vision is due to a drop in blood pressure. This is a normal consequence after anesthesia, as it is a great burden for the entire human organism. After sufficient fluid intake and sufficient bed rest, the problem should disappear by itself.
Another symptom that can possibly be caused by anesthesia is the so-called eye migraine. It is painless and characterized by bright flashes in the field of vision, which appear and disappear spontaneously. An eye migraine is caused by a temporary lack of blood supply to the brain in the area of the visual cortex.
The cause can be a vascular spasm, for example. However, an actual connection with an operation or anesthesia has not been proven. Since the procedures of anaesthesia are well understood and there is a lot of experience, anaesthesia can be safely used in children.
Of course, there is also the potential for side effects in this particular patient group. First of all, children, like everyone else, can suffer a side effect typical of this procedure even after anaesthesia. These include, above all, postoperative nausea associated with vomiting (PONV).
This not infrequent side effect is observed more frequently in children than in adults, but is usually self-limiting a few hours after anaesthesia. In severe cases, there are various effective remedies available for nausea.Another side effect, the postoperative tremor after anesthesia, is also more frequently described in children, as they are more sensitive to cold due to their physical conditions. Here, blankets and, if necessary, warm infusions help.
Immediately after waking up from the anesthesia, children are often confused and do not know where they are, which, compared to adult patients, causes sometimes strong anxiety or even panic, so that the presence of parents in the waking phase is not unimportant. The children can scream and cry loudly. However, this is a reaction to the drugs still working in the body and the confusion, it should not be misinterpreted as pain, as sufficient pain medication has been given.
A popular anaesthetic is the gas sevoflurane. This has the advantage over other inhalation anaesthetics that it irritates the respiratory tract less and reduces the occurrence of coughing, hoarseness and also pain after anaesthesia. It is therefore often used for anaesthesia in children.
However, a certain side effect, agitation, can occur. This means that the children are very active postoperatively and sometimes behave as if they were in a hurry. In more pronounced cases, they can hardly be sedated and wander around aimlessly.
However, this is one of the rare side effects of anesthesia in children and goes away on its own. Another thing that should not be ignored is the possible traumatization of the child by the procedure. Therefore, it is important in the run-up to the operation to make the child, together with the doctor and the parents, at least partially understand the processes of the anaesthesia and to create a positive atmosphere before and after the anaesthesia.
Elderly people form a special patient group, since older patients often have several concomitant diseases and may react differently to medical interventions than younger patients. This means that side effects are more likely to occur during an anaesthetic. In older patients, cognitive side effects, i.e. those affecting consciousness and brain function, play a major role.
Postoperative delirium is a relatively common side effect of anesthesia after surgery. Various brain functions, such as memory, orientation in space or time, and even general consciousness, may be restricted. This side effect occurs in older patients a few hours to days after the anaesthesia, with a frequency of about 5-15%, which can increase to 50% in very complex and long operations.
To be distinguished from postoperative delirium is postoperative cognitive dysfunction. The difference is that this side effect does not occur until days or weeks after anesthesia. The described disorders of concentration and memory are similar.
More detailed information on this topic can be found in the article: Anaesthesia in elderly peopleThese side effects, which are more frequently described, especially in elderly patients, are in most cases not permanent and do not leave any long-term damage. In individual cases, however, according to recent studies, long-term damage can occur. For example, it is currently being discussed whether anaesthesia can accelerate or trigger dementia in older people.
The mechanism behind this is not yet understood. Overall, however, these are isolated reports; the majority of elderly people operated on under anaesthesia suffer only mild or none of the side effects described above. In addition to the cognitive, consciousness and thinking related side effects, there are of course also generally known side effects of anesthesia in older patients.
These typically include PONV (post-operative nausa and vomiting), which manifests itself through nausea and vomiting after anesthesia. This can be extremely unpleasant, but usually lasts only a few hours after surgery and can usually be treated well with medication. Also known as a side effect of anesthesia is postoperative tremor.
Probably caused by temporary hypothermia during the procedure, this is also usually a harmless side effect. In addition, due to the reduced resistance compared to younger people and possible side effects, the recovery time after an anesthesia can be longer.
