Alcohol Use Increases Risk Of Surgical Complications

By Hugh C. McBride

In addition to ruining health, destroying relationships, and inflicting severe emotional and financial damage, alcoholism may also be responsible for potentially life-threatening difficulties during recovery from surgery.

Studies by German researchers have determined that ingesting even moderate amounts of alcohol before being operated on can weaken a patient’s immune system and increase the likelihood of developing post-operative infections. And several health care professionals have warned that failing to disclose a history of alcoholism prior to surgery can cause dangerous complications and limit caregivers’ ability to properly diagnose and treat these conditions.

“Everybody, sooner or later, will likely have an operation for one reason or another,” Jan-Philipp Braun, a researcher with the University of Berlin’s Charité Hospital, wrote in the September 2005 issue of Alcoholism: Clinical & Experimental Research. “How much an individual drinks on a daily basis may have a significant impact on his or her recovery.”

INCREASED RISK OF INFECTION

The study in which Braun participated was designed to assess the strength of the immune systems of individuals who had a history of drinking to excess. According to a Sept. 15, 2005 article on the Time magazine website, Braun and his fellow researchers followed the progress of 44 patients – 10 of whom had been identified as “long-term alcoholics” – before and after they had elective heart surgery. Time writer Alice Park reported that an analysis of five blood samples taken before and after the surgeries led researchers to the following conclusions:

  • The 10 alcoholic patients were four times more likely to develop post-surgical infections than were their non-alcoholic counterparts.
  • The blood samples of the 10 heavy drinkers showed elevated levels of cortisol and interleukin-10 – two compounds that have been known to impair the proper functioning of the immune system.
  • Because of alcohol’s ability to affect the immune system, doctors should pre-screen for alcoholism, and should put patients whose blood tests indicate heightened levels of immune-suppressing substances on a regimen of pre- and post-surgical immunotherapeutic drugs.

The February 2008 issue of Alcoholism: Clinical & Experimental Research contained a second study by University of Berlin researchers on alcohol’s effects on surgical success. In a Feb. 4 article in the British newspaper The Guardian, writer Alok Jha described the German scientists’ efforts to explore how pre-surgical ingestion of alcohol would affect the recovery of laboratory rats:

The scientists … carried out abdominal surgery on 32 rodents that had been fed either alcohol or a placebo for eight days. They were then infected with pneumonia.

The results … showed that mice given alcohol before surgery suffered worse lung damage and produced higher levels of two types of immune system chemicals called cytokines, a sign that the immune system is working to fight a severe infection.

“The immune system of the alcohol-exposed mice tried in vain to fight off the infection and produced excessive amounts of [cytokines] in the process,” said [researcher Claudia Spies, an intensive care specialist]. “The pneumonia was also more severe in the alcohol-exposed mice than in the animals that had only been exposed to the bacteria but not to the alcohol.”

Though their prolonged exposure to alcohol can put alcoholics at higher risk for the types of problems indicated in these studies, personnel who participated in the research were quick to point out that even moderate drinkers could experience difficulties if they fail to abstain before entering the operating room.

“A significantly high rate of complications can develop in patients who consume alcohol at levels that are less than excessive.” Spies told Jha. “Patients who are considering surgery should definitely control their drinking habits in advance.”

ALCOHOL WITHDRAWAL AFTER SURGERY

Infection isn’t the only risk faced by alcohol-dependent surgical patients. Those who fail to disclose their drinking history before undergoing surgery risk complicating their recovery by going through alcohol withdrawal at the same time.

Posing a threat to one’s health whenever they occur, withdrawal symptoms such as delirium tremens, hallucinations, and seizures can have devastating effects on individuals who are in weakened post-operative states. Not only are patients’ bodies ill-equipped to deal with these issues so soon after surgery, but their appearance may mask symptoms of other conditions that were caused by the surgery – and thus could cause post-op personnel to misdiagnose or incorrectly medicate the patient.

According to information on the Heart and Vascular Institute section of the Cleveland Clinic’s website, patients who inform their doctors of their drinking history before undergoing heart surgery – and who, as a result, undergo withdrawal treatment before going under the knife – are more likely to experience the following positive results:

  • Decreased occurrences of post-operative seizures and delirium tremors
  • Reduction in the use of potent sedatives
  • Decreased length of post-operative hospital stay
  • Less time on the ventilator after surgery
  • Lower incidence of organ failure and biochemical complications

In a post on her Surgery Blog, former intensive care unit nurse Jennifer Heisler left little room for doubt about her advice on whether patients should disclose their drinking history. “Talk to your surgeon,” she wrote. “Be honest. It could save your life.”

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Source: JoinTogether Online