Post Anesthesia Complications / Status Post Cosmetic Surgery
Dr. Linder has been filming today for Entertainment Tonight on February 3, 2014. The topic of discussion is Post Anesthesia Hallucinations and Psychosis. In general, after speaking to our Board Certified Anesthesiologist regarding the topic of Post Anesthesia Psychosis, this is not something that we believe truly exists. We should differentiate emergence delirium versus ICU psychosis. Emergence delirium may occur as seen in pediatrics when a child awakes with agitation.
In our practice we do see younger patients who have post anesthetics under general and may have emergence delirium due to Post traumatic Stress Disorder as well. These patients can be treated quickly verbally as well as protection of them from harming themselves and using small doses of Versed or short-acting Benzodiazepine, a valium-like drug. The situation will normally resolve in just a few minutes and the patient may re-emerge after being given the valium or Versed without agitation. ICU psychosis is multi-factorial and may be associated with disorientation associated with environment of pain, lights on for 24 hours, activity such as vital signs that are taken and the patient becomes completely disoriented and progresses to a state of psychosis. This can also be treated with medications and will resolve. The anesthetic ketamine is a dissociative anesthetic which can be associated with a psychotic event. We do not use this in our practice. It is notable that patients having surgery over 4-1/2 hours under general anesthesia do increase the risk of anesthetic-related complications. The most common anesthetic-related complications include cardiac, respiratory and neurological. Our patients are monitored both pre- and postoperatively and intraoperatively with the anesthesiologist. Preoperative evaluations must include full history, physical, and psychological evaluations prior to undergoing any surgical procedure, including plastic surgery.