How PTSD affects your body in surgery

#ptsd #mentalhealthawareness #mindbodyconnection

Your body keeps score of past traumas. PTSD can impact your body under anesthesia when you're having surgery - learn how from Dr. Kaveh.

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0:00 - Introduction
0:36 - Why PTSD matters before surgery
0:57 - #1: state-dependent memories
1:42 - GABA agonists "recreating" traumatic states
2:02 - Dissociative amnesia and flashbacks
2:24 - Hyperarousal in surgery and emergence delirium
3:27 - #2: PTSD medication interactions
4:34 - Cannabis and recreational substance interactions
4:44 - Increased anesthesia requirements and underdosing
5:24 - #3: Your body's score card and central sensitization
6:22 - Central sensitization complications
6:57 - What to do if you have PTSD before surgery
8:15 - Advocate for loved ones!

Understanding how PTSD impacts the body during surgery is crucial for both patients and healthcare providers. In this video, we dive into the intricate ways traumatic stress alters memory processing, leading to flashbacks or memory loss, and how this intersects with the effects of surgery and anesthesia.

Surgery, a form of traumatic stress, disrupts memory processing, akin to the effects seen in PTSD. Both conditions may involve changes in glutamate levels, contributing to a heightened state of fear and anxiety. We explore the similarities between combat PTSD and civilian PTSD, often triggered by traumatic incidents like assaults, falls, gunshot wounds, or abuse.

Key Points Covered:
- The emergence of state-dependent memories under anesthesia and their impact on post-operative recovery.
- Risks associated with emergence delirium and post-operative delirium, including increased chances of post-operative cognitive dysfunction (POCD), prolonged PACU stays, and potential threats to patient and provider safety.
- The interaction between long-term use of recreational and prescription drugs (e.g., opioids, TCAs, mirtazapine) and anesthesia, highlighting the complexities in managing PTSD patients in surgical settings.
- The concept of central sensitization of the spinal cord and its implications for pain management and medication side effects.
- We also discuss best practices for anesthesia management in PTSD patients, such as the cautious use of benzodiazepines and the potential benefits of Precedex and ketamine due to their effects on glutamate modulation.

REFERENCES:
https://www.frontiersin.org/articles/...
https://news.northwestern.edu/stories...
https://www.bmj.com/content/384/bmj-2...
https://assets.cureus.com/uploads/cas...
https://academic.oup.com/painmedicine...
https://pubmed.ncbi.nlm.nih.gov/14770...
https://academic.oup.com/milmed/artic...


This video/speech/channel DOES NOT CONSTITUTE MEDICAL ADVICE. Patients with medical concerns should contact their physician. If your concern is an emergency, immediately call 911. This information is not a recommendation for ANY THERAPY. Some substances referenced in this content may be illegal, and this content is not a recommendation for, or endorsement of, their use in any way.