What Causes Extreme Confusion, Depression And Agitation Post A Total Knee Replacement Surgery?

Posted on Fri, 11 Mar 2016

Question: My 91 year old father had a total knee replacement 7 days ago. His knee is healing nicely but he has become extremely confused, disoriented, depressed and agitated. He's also had some hallucinations and a lot of short term memory loss. It's like he's a totally different person. I have told home health and they have sent word to his surgeon. His resting pulse rate was 112 and his hands were trembling so badly. They had me cut back on the oxycodone he was taking for pain and use mostly Tylenol. For the last 2 days he's only had a total of 4 taken mainly before PT when pain was 6-8. I just don't know what's wrong or what to do.

Answered by Dr. Neeraj Kumar (45 minutes later)

Brief Answer:
Require investigation and treatment under guidance

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.

Altered behaviour and sensorium post surgery may be due to infection, electrolyte imbalance, drug effect or some vascular stroke event occurring during operation and anesthesia.
You should get him checked again by treating doctor and get a neurologist consultation for examination.
Some blood investigation are required like counts, serum sodium, potassium, urea, creatinine, liver function test.
Brain imaging may be done if suspected neurodeficit.

It's better to get him examined, investigated and if required admitted for evaluation and treatment.
Hope you found the answer helpful.
Do get back to me for further queries.

Regards
Dr N Kumar
Neurologist

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Above answer was peer-reviewed by : Dr. Vaishalee Punj