Research reveals potential for post-operation brain damage

A hidden risk related to post surgery brain function, revealed in a study by University College London and City, University of London, could make people reconsider elective procedures.

Neurologist Dr Mona Chetan Thakre said there should be awareness of the cognitive effects of operations. Reem Mohammed / The National

DUBAI // New information highlighting the risk of post-operation brain damage could make those who are planning cosmetic surgery to think again.

A culture of cosmetic and bariatric surgery is growing in the UAE but a study by the City, University of London institute and University College London compares the effect of oxygen deprivation in mountaineers with that experienced by patients under general anaesthetic.

The researchers found that the deprivation could result in patients not having full cognitive function for up to five days.

“Those who are diabetic or have heart issues are more at risk from cognitive dysfunction,” said Dr Mona Chetan Thakre, a neurologist at Zahra Dubai Hospital.

“About 80 per cent will fully recover but some have short-term debilitating effects and it can be a worry for the family. The awareness should be there among doctors so they can warn relatives before surgery.”

Speech is rarely affected, Dr Thakre said, but personality and behavioural change was not uncommon.

Very rarely, patients will not fully recover brain function. This is usually if they are predisposed with a neurological disorder such as Parkinson’s or dementia.

“It is not uncommon to see patients come out of surgery with anxiety and depression, but we try to prevent it as well as we can by monitoring any post-operative infections or blood sugar levels, particularly in diabetics,” Dr Thakre said.

“It should be a consideration for patients choosing to have cosmetic or bariatric surgery.”

University researchers claim as many as 4.6 million people worldwide could be affected by post-operative cognitive deficits each year.

The figure is based on 2 per cent of the 230 million people who had major operations in 2012 reporting a short-term problem in their cognitive function after surgery, while a significant proportion had longer term difficulties.

Dr Amit Kaul, a specialist in bariatric surgery at Medcare Hospital Jumeirah, said the elderly were more at risk.

“Each case varies, so it is hard to generalise but cognitive impairment does happen and can last for a month or so post surgery,” Dr Kaul said.

“Patients undergoing a hip or knee operation are usually under anaesthetic for between 90 minutes and two hours.

“Patients commonly suffer short or long-term memory loss, but we make sure they are fully orientated when they are with us and they can recognise family members and surroundings.”

In the research, climbers took a neuropsychological test to assess language, attention and memory at different altitudes, with results compared to a control group at sea level.

Those who had climbed Everest presented symptoms of oxygen deprivation, or hypoxic brain damage – also a side effect of taking general anaesthetic ­during an operation.

Experts said this could be the reason many people struggled to return to work following a significant operation.

Dr Abdul Aneez, a specialist anaesthesiologist specialist at Medeor 24x7 Hospital in Dubai, treated a man involved in a road accident who struggled to recover full cognitive function after four hours in surgery.

“When he came round he wasn’t talking much, so I thought it was a language problem,” Dr Aneez said.

The Turkish labourer began to get drowsy over the next few hours and was then put on a ventilator to assist with breathing. He remained in hospital for a further four weeks.

“He was showing symptoms of hypoxic brain damage,” said Dr Aneez. “He was lucky to recover most of his brain function.”