Time under general anesthesia associated with postoperative complications in head and neck surgery

July 18, 2005

CHICAGO - The amount of time a patient is under general anesthesia during major head and neck surgery, not their age, was associated with postoperative complications, according to an article in the July issue of Archives of Otolaryngology - Head & Neck Surgery, one of the JAMA/Archives journals.

The elderly population in the United States is expected to rise from 34.7 million in 2000 to 69.4 million persons older than 65 years in 2030, according to background information in the article. This may result in increased numbers of elderly patients requiring major head and neck surgical procedures. As age has received increased attention as a predictive factor for postoperative complications, so has the question of the appropriateness of candidates for surgery based on age.

Marina Boruk, M.D., from the State University of New York Downstate Medical Center, Brooklyn, and colleagues, conducted a retrospective study of medical records, between January 1999 and January 2004, to determine if age alone is a predictor of outcomes for major head and neck surgery. The review included 157 cases of patients who had undergone a major head and neck surgical procedure, of whom 31 (20 percent) were 70 years or older. The age of patients ranged from nine to 95 years, with an average of 56.1 years. Fifty-nine percent (92) were men and 41 percent (65) were women.

Patient's age alone was not found to be a predictive indicator of outcomes for major head and neck surgery. Time under general anesthesia (TUGA) was the only factor found to be consistently related to surgical complications and length of hospital stay. TUGA ranged from 75 to 1,160 minutes, with a median (middle value) of 240 minutes. The odds of a patient having a complication increased by 0.6 percent with every minute of anesthesia, therefore the odds of having a major complication increased by 36 percent every hour under anesthesia. The odds of having any complication (major or minor) increased by 18 to 36 percent for every hour under anesthesia, depending on the analysis. Being 70 years or older was not associated with complications or length of stay (LOS) in any of the researchers' analyses. The median length of stay for patients was three days in males and two days in females.

"Our findings support the growing acceptance that age, in and of itself, is not a risk factor for major head and neck surgery. ... Care should be taken to carefully control preoperative comorbid conditions and offer the appropriate medical care," the authors write. "TUGA showed a statistically significant relationship with complication rate and hospital LOS in multivariate analyses. This relationship held true for all age groups."
(Arch Otolaryngol Head Neck Surg. 2005; 131:605-609. Available pre-embargo to the media at www.jamamedia.org.)

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or email mediarelations@jama-archives.org.

The JAMA Network Journals

Related Anesthesia Articles from Brightsurf:

Does general anesthesia increase dementia risk?
There are concerns that exposure to general anesthesia during surgery may contribute to an increased risk of Alzheimer's disease.

Cannabis use prompts need for more anesthesia during surgery, increases pain
Not only might cannabis users require more anesthesia during surgery than non-users, they may have increased pain afterwards and use higher doses of opioids while in the hospital, suggests first-of-its kind research being presented at the ANESTHESIOLOGY® 2020 annual meeting.

COVID-19 testing of children before anesthesia saves PPE
Universal COVID-19 testing of children who are having procedures requiring anesthesia promotes efficient use of personal protective equipment (PPE), according to research being presented at the ANESTHESIOLOGY® 2020 annual meeting.

How do we disconnect from the environment during sleep and under anesthesia?
A series of new studies by researchers at Tel Aviv University's Sackler Faculty of Medicine and Sagol School of Neuroscience finds, among other important discoveries, that noradrenaline, a neurotransmitter secreted in response to stress, lies at the heart of our ability to ''shut off'' our sensory responses and sleep soundly.

Scientists unveil how general anesthesia works
The discovery of general anesthetics -- compounds which induce unconsciousness, prevent control of movement and block pain -- helped transform dangerous operations into safe surgery.

Surgery with anesthesia not linked to indicator of Alzheimer's, Mayo study finds
Older adults who have surgery with general anesthesia may experience a modest acceleration of cognitive decline, even years later.

Choice of anesthesia may affect breast cancer metastases
A new study led by Stony Brook University Cancer Center researchers to be published in Nature Communications suggests that the choice of anesthesia may change the metastatic process of breast cancer by affecting the cytokine and microenvironment.

Is headache from anesthesia after childbirth associated with risk of bleeding around brain?
This study examined whether postpartum women with headache from anesthesia after neuraxial anesthesia (such as epidural) during childbirth had increased risk of being diagnosed with bleeding around the brain (intracranial subdural hematoma).

Music can be a viable alternative to medications in reducing anxiety before anesthesia
Music is a viable alternative to sedative medications in reducing patient anxiety prior to a peripheral nerve block procedure, according to a new Penn Medicine study.

In cases when patients under anesthesia experience anaphylaxis, hyperactive immune...
A study of 86 patients reveals how drugs used for anesthesia can induce life-threatening anaphylaxis (a dangerous type of allergic reaction) through an alternative immune pathway.

Read More: Anesthesia News and Anesthesia Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.