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Are you Partly Conscious Under Anesthesia?

  • Although anesthesia is an extremely common and crucial part of the world of medicine today, there are still many unanswered questions about how it actually works. Many aspects of anesthesia are constantly being researched and explored, and new discoveries are constantly being made. One question that is often asked by patients and physicians alike, is are you partly conscious under anesthesia? A new study performed by the research group of Adjunct Professor of Pharmacology and Anaesthesiologist Harry Scheinin studying anaesthesia mechanisms, and the research group of Professor of Psychology Antti Revonsuo studying human consciousness and brain from the point of view of philosophy and psychology, aims to answer this common question. The first part of this study involved healthy adults who were anesthetized with dexmedetomidine or propofol, while being monitored with an electroencephalogram (EEG) and a positron emission tomography (PET). The drugs were given to the subjects until they had just almost lost responsiveness. They could then be woken up with loud talking or a light shake. As soon as the person regained responsiveness, they were asked if they experienced anything during their time under anesthesia. Nearly all the participants said they experienced something similar to a dream. The subjects also were played sentences, half which ended normally and half that ended in a strange way. One unexpected sentence, for example, was “The night sky was filled with shimmering tomatoes”. If the subject heard the strange sentence when they were awake, a reaction would show on the EEG. However, when they were under anesthesia, their brains could not tell the difference between the normal and strange sentences. The activity on the EEG did show, however, the brain was trying to interpret the meaning of the words. When the patients woke up from the anesthesia, they had no memory of the sentences. The subjects in this study were lastly played very unpleasant sounds while they were under anesthesia. When they woke up, they were played these sounds, along with others that had not been played before. The participants reacted quicker to the sounds that had already been played. So can we answer the common question are you partly conscious under anesthesia? The results of this study has lead researchers to believe that consciousness is not completely lost when a patient is put under anesthesia, even though the person is not reacting to what is happening around them. The brain may try to understand words and register speech while under anesthesia, but they will not remember when they are woken up and regain full consciousness. “The state of consciousness induced by anaesthetics can be similar to natural sleep. While sleeping, people dream and the brain observes the occurrences and stimuli in their environment subconsciously” summarises Professor Revonsuo. “Anaesthesia could resemble normal sleep more than we have previously thought” adds Dr. Scheinin. While this topic will continue to be researched, these findings are extremely helpful to doctors and patients hoping to understand anesthesia a bit more.

    17 Jul
    17 Jul
  • Having a child with health issues can be extremely stressful on parents and guardians, especially when the young child needs to undergo a serious procedure that requires anesthesia. While parents are often apprehensive about the effects anesthesia may have on their child in the future, a new study from the Mayo Clinic shows anesthesia in young children is not linked to a lower IQ. This topic is often researched, and the results from this particular study should be reassuring to parents with children in need of surgery. This particular study researched a group of 997 children born between 1994 and 2007, all from the same county. 380 of these children had been exposed to anesthesia once before the age of three, 206 children had been exposed to anesthesia two or more times, and 411 children had never been exposed to anesthesia in their lifetime. 42% of those studied had received anesthesia due to a surgery for medical conditions involving the ears, nose, and throat. The group was given brain function tests between age 8 and 12 and again between age 15 and 20. When the results from this study were assessed, there were no significant differences between the three groups in the areas of intelligence, memory, and other brain functions that were measured. Children exposed to anesthesia multiple times before the age of three did, however, have a slight decrease processing speed of the brain and in fine motor coordination. These children also had a greater likelihood of behavioral problems and learning difficulties.  This is evidence that anesthesia in young children is not linked to a lower IQ. “These secondary outcomes must be interpreted cautiously,” write the researchers, “but [they] suggest … that exposure to multiple procedures requiring general anesthesia is associated with a subtle, specific pattern of injury that may have consequences for subsequent learning and behavior.” This was an observational study, which means the results that showed lower scores in motor skills and brain processing, could be unrelated to the multiple exposures to anesthesia. Dr. David Warner, the study’s lead author and a pediatric anesthesiologist at the Mayo Clinic Children’s Center in Rochester doesn’t want this study’s findings to scare parents.  “The last thing I want to do is prevent any child who needs an operation from getting it because of this,” he said. “Overall, the results are pretty reassuring,” said Dr. David Warner,“There’s not much evidence that a single exposure is associated with any harmful outcome.” Of children that need surgery before the age of three, more than 80% of children only undergo that one procedure. While this topic is still being researched, this study should give parents some peace of mind wthat anesthesia in young children is not linked to a lower IQ. The results show that when the benefits of the surgery outweigh the risks of anesthesia, parents should be able to make the decision with less stress and worry. If you or someone you know is preparing for surgery that requires anesthesia, head to the Anesthesia Information for Surgery Patients section of our website.

    25 Apr
    25 Apr
  • Studies on anesthesia are continuously providing us with new information and a better understanding of the effects it may have on patients undergoing surgery. Many people are apprehensive before undergoing any procedure, but especially when it requires general anesthesia. Many studies have been conducted to answer the question can anesthesia cause memory problems? A new study shows that any cognitive changes in patients after anesthesia are very small and insignificant. The study analyzed a group of middle-aged men and women, with an average age of 54 years old. 312 who had had one or more procedures that require general anesthesia and 652 people who had never been under general anesthesia. None of the people studied had ever had neurological or heart surgery, because both can affect cognitive performance. At the start of the study, all participants had normal cognitive functioning. The results of the study showed that on average, the participants who had been under general anesthesia had small declines in immediate memory over a four year period. It also showed that people who were exposed to general anesthesia for longer periods of time, for longer surgeries, showed greater declines in executive functioning, which includes skills like planning and focusing. While small changes were seen, study author Dr. Kirk Hogan, a professor of anesthesiology at the University of Wisconsin-Madison School of Medicine and Public Health, said “the cognitive changes after surgery are small — most probably asymptomatic and beneath a person’s awareness,” Although this study did show some minor declines, researchers say the study results still cannot directly tie cognitive performance declines to anesthesia. Other conditions, the surgery itself, and other factors may affect these declines in the people involved in the study. This topic will continue to be studied, but this should give patients some peace of mind knowing that if there is some type of cognitive decline due to anesthesia, it is very insignificant and not noticeable to the average person. To learn more about anesthesia and what you need to know before a procedure, visit the Anesthesia Information for Surgery Patients section on the Steel City Anesthesia Website.

    09 Mar
    09 Mar
  • In today’s modern world, the use of anesthesia during a medical procedure has become a necessity and is extremely common. The luxury of being “asleep” and feeling no pain during a surgery is something we can’t imagine living without this day in age. This was not always the case, and the first use of anesthesia took place in 1846 during a procedure to remove a tumor in a patient’s neck. At that time, the drug of choice was ether which did indeed knock the patient unconscious, but unfortunately was extremely dangerous. Today, there are many options anesthesiologists can use, however it is still not completely clear how the process of anesthesia works. A recent study has shown like humans, plants react to general anesthesia. Scientists and doctors are continuously researching the science of anesthesia and we are constantly finding out more about the process. One group of researchers formed a study that explored the effects of anesthesia on plants and concluded that plants react to general anesthesia. Scientists have known for some time that plants are affected by anesthesia, in fact, Claude Bernard discovered this over one hundred years ago. This new study explored this fact even further and had the goal of understanding the link between the plant and animal system in terms of anesthesia. One of the plants used in this study was Dionaea muscipula, also known as the venus flytrap. Researchers first observed the venus flytrap as it functions normally, where triggering hairs in the plants trap causes it to snap shut. After exposing the plant to diethyl ether gas, the plant is unresponsive to the trigger. After 15 minutes, it seems the plant recovers and then responds to a trigger. The team of scientists conducting this research, hope their results from this study will help unlock the mystery of how anesthesia works in humans. The team of researchers from Germany, Japan, the Czech Republic, and Italy published their study in Annals of Botany. This ongoing research is helpful to doctors and anesthesia providers, as well as to patients. The more information patients have on the process of anesthesia, the more they can be at ease when preparing for a procedure. If you or someone you know is preparing to go under anesthesia, click here to visit the Steel City Anesthesia website for more information.

    05 Feb
    05 Feb
  • Any type of surgery is likely to cause anxiety and fear in patients of all ages. However, surgery can be a completely terrifying and stressful experience for children. This can pose a problem for medical professionals, especially when administering anesthesia to these young patients. Doctors, nurses, and other medical professionals have used different techniques over the years, hoping to calm patients down before procedures and treatments. While stickers and toys have been very helpful, medical professionals are now finding that new technologies are very effective.  The latest finds that virtual reality calms young surgical patients more effectively than other methods. Thanks to a group of pediatric specialists at Lucile Packard Children’s Hospital Stanford, virtual reality calms young surgical patients.  A technique that has been helpful for older children, is giving them a virtual tour of the hospital and operating room beforehand so they know exactly what to expect on the day of their surgery. Zack Dwyer, a 17 year old preparing for surgery to correct supraventricular tachycardia, strapped on virtual reality goggles on Tuesdays and Thursdays after school, taking a virtual trip through the hospital starting at the entrance and ending in the recovery room. He had an opportunity to see exactly what he was going to see on the day of his surgery, even what it would look like as he was lying in the operating room speaking to a surgeon. After undergoing his procedure, Dwyer said “It definitely would have been super overwhelming if I didn’t know that was coming”. While this technique works great for teenagers, younger children can be a bit more difficult. Administering anesthesia to frightened children can be a challenge as their fear leads them to squirm and pull off their anesthesia masks. For these kids, virtual reality video games are used to distract them and trick them into breathing the anesthetic. One game, Sevo the Dragon, takes breathing anesthetic through a mask and turns it into an enjoyable game. Children pick a dragon avatar and the type of food they want to “cook” using the dragons fiery breath. The patient continues to play the game until they fall asleep. While these techniques are still in their early stages, they are already seeing how virtual reality clms young surgical patients, reducing their fear and anxiety on the day of their surgery. This technology is primarily being used on children at the moment, but it may be a helpful distraction for older patients as well. A reduction of stress and anxiety in patients undergoing anesthesia is helpful to the person as well as the medical professionals assisting with the procedure.

    20 Dec
    20 Dec
  • As children, our mother’s healing voice was always something that could calm us down and make us feel better. Even now as adults, many people will still give their Mom a call when faced with a stressful situation. Researchers have recognized this, and are hoping to determine if a mom’s voice helps reduce emergence delirium if children hear their mother’s healing voice in a recording after anesthesia. After a procedure, children recovering from anesthesia sometimes experience a behavioral disturbance known as “emergence delirium.” The condition may cause patients to become very confused or experience hallucinations, which can be stressful for the children as well as caregivers and parents. Aside from being extremely uncomfortable and frightening, emergence delirium can be dangerous. Children sometimes move violently, injuring themselves and opening incisions. Researchers in South Korea believe a mom’s voice helps reduce emergence delirium. Studies in the past have shown that a mother’s voice can activate certain areas in the brain, affect behavioral and neural responses, and involuntarily cause children to be more attentive. The study included 66 children between the ages of two and eight recovering from eye, ear, nose, or throat surgeries. Half of the children heard a recording of their mother’s voice asking them to wake up over noise-cancelling headphones, while the other half heard a stranger saying the same words. Researchers will examine the results, and determine whether or not the children who heard mom’s voice helps reduce emergence delirium than the children who heard the voice of a stranger. This study has just recently concluded, and researchers are still studying and analyzing the results. If they do find a link the mom’s voice helps reduce emergence delirium in children, it will be a great option for medical professionals to use to keep children safe and reduce the child’s stress and anxiety following anesthesia.

    06 Nov
    06 Nov
  • Living in the United States, access to electricity is something we take for granted. If you’re going to a hospital in the US, you never have to worry about the electricity cutting off for hours at a time without warning. Unfortunately, for many people in other parts of the world, electricity is limited and often very unreliable. To have brownouts and power spikes is a regular occurrence and happens often over the course of a day, which is why battery powered anesthesia machines are saving lives. This is a huge issue for hospitals in rural parts of the developing world. These power outages force surgeons to postpone and hold off on operations, which often costs patients their life.  But battery powered anesthesia machines are changing all of that. A nonprofit medical device company, Gradian Health Systems, has developed a groundbreaking device called the Universal Anesthesia Machine, or UAM, which are battery powered anesthesia machines in which workers in countries such as Malawi, SIerra Leone, and Zambia can administer anesthesia without electricity. This device can be a huge factor in saving the lives of many patients around the world. “We knew that the need was insatiable, frankly, given the number of hospitals and the number of countries that experience these challenges,” said Erica Frenkel, cofounder and COO of Gradian Health Systems. “We have a pretty good shot here at making a big dent in what is otherwise a really challenging issue.” Besides usually requiring electricity, medical grade pure oxygen is also needed to deliver anesthesia to patients. In U.S. hospitals, pure oxygen is manufactured on-site, but in hospitals in the developing world, this is not possible. The UAM are not only battery powered anesthesia machines, but they also can solve the problem for hospitals needing pure oxygen. The machine uses an integrated oxygen concentrator, that allows the machine to generate its own oxygen. When cylinder, pipeline, or portable oxygen is available, the machine can use it, but the UAM automatically draws in room air as the “carrier gas” to create pure medical-grade oxygen suitable for delivering anesthesia. The Universal Anesthesia Machine can operate for up to six hours using a rechargeable energy, meaning doctors won’t have to postpone surgery if the electricity goes out, saving the lives of patients. Gradian’s mission is to not only train people how to use the machine, but also how to fix it. A power outage during surgery is something, as Americans, we are blessed to not have to worry about. These battery powered anesthesia machines can ease the minds of doctors operating on patients in developing countries. It will give them peace of mind knowing that if something goes wrong, there is a machine that will provide backup. To see Erica Frenkel’s TED talk on the Universal Anesthesia Machine, CLICK HERE.

    25 Sep
    25 Sep
  • Researchers in the past have been concerned of the effects of Anesthesia during youth oral cleft surgery, worrying it would cause cognitive impairment later in life. This has caused a great deal of worry and anxiety for many parents. Oral cleft surgeries in particular were thought of to have the highest risk, due to how early they are performed in a child’s life. Some studies have shown that children that undergo surgery from an oral cleft often experience cognitive dysfunction, and face many academic challenges. While some thought this may be linked to anesthesia at such a young age, a recent study has proven this to be untrue. Researchers from the University of Southern Denmark and the University of Iowa have recently published results of a study examining the theory that there is no connection between anesthesia exposure and cognitive impairment. Researchers studied a group of 558 teenagers who had undergone surgery for cleft lip, cleft palate, or both at a young age. Research showed that 509 of the oral cleft children had undergone at least one cleft operation and were exposed to an anesthetic. Results of the study done on the adolescents that underwent cleft surgery were compared to a control group. Although these teenagers in the study were exposed to anesthesia at a very young age, researchers found no significant difference in the teens that underwent cleft lip surgery, cleft palate surgery, or both, and the teenagers in the control group. Leading researchers to believe there is no link or negative effects of anesthesia during youth oral cleft surgery. One difference they did find was that adolescents that had only had cleft palate surgery did have lower test scores than those in the control group, but their surgeries were generally performed later than children with other types of clefts. “This finding is remarkable,” said Dr. Nicola Clausen of the research group. “Studies like the present one cannot definitely prove that anesthetic drugs do not harm developing brains. However, it can put the potential threats into perspective because other factors more importantly impact these children’s neurocognitive development.” While there is still research being done on the effects of anesthesia during youth oral cleft surgery, studies like this can give parents of children needing these surgeries some piece of mind before their child is put under anesthesia. If you or someone you know is preparing for a procedure requiring anesthesia, click here to visit our anesthesia information page to find out more.

    21 Jul
    21 Jul
  • While it is no surprise that children of all ages enjoy animated movies and TV shows like Disney’s Cars, Spongebob Squarepants, and Despicable Me, watching these types of movies may replace general anesthesia for kids with cancer, according to a recent study. Research presented at the European Society for Radiotherapy and Oncology 36 (i.e. “ESTRO”) conference, showed results of a study involving 12 children between the ages of 18 months and 6 years receiving radiation treatment for different types of cancer. While cancer in children is relatively rare, with about 215,000 new cases each year, about a sixth of those children require treatment with radiotherapy. During these treatments, children are required to remain motionless, which is often a challenge, as any parent will tell you who’s had to give their kids medicine, let alone administering radiation treatment. General anesthesia is used to keep the children still, which can be costly and requires the children to fast for at least 6 hours before the treatment. While this can be challenging, watching movies may replace general anesthesia for kids with cancer as it has some of the same side effects needed to administer the treatment. Catia Aguas, a radiation therapist and dosimetrist at the Cliniques Universitaires Saint Luc, Brussels, Belgium, says “We wanted to see if installing a projector and letting children watch a video of their choice would allow them to keep still enough that we would not need to give them anesthesia.” In the study, six of the children received treatment before a video projector was installed and six children received treatment while watching their favorite movie. Before the video was available, general anesthesia was needed for 83% of the treatments, and after projector was installed, anesthesia was needed in only 33% of treatments. “Radiotherapy can be very scary for children. It’s a huge room full of machines and strange noises, and the worst part is that they’re in the room alone during their treatment. Before their radiotherapy treatment, they have already been through a series of tests and treatments, some of them painful, so when they arrive for radiotherapy they don’t really feel very safe or confident. Since we started using videos, children are a lot less anxious. Now they know that they’re going to watch a movie of their choice, they’re more relaxed and once the movie starts it’s as though they travel to another world.” said Aguas. President of ESTRO, Professor Yolande Lievens, head of the department of radiation oncology at Ghent University Hospital, Belgium, said: “The success of this project is good news for young patients, their families and their medical teams. Simply by installing a projector and showing videos, the team have reduced the need for anesthesia and reduced anxiety for these children. For parents this means they no longer have to watch their child going under a general anesthetic and then into the recovery room after treatment every day for weeks on end. In addition, the use of videos had a positive impact on the workflow in paediatric radiotherapy, which further increased the positive effect observed by the caregivers as well.”   Watching movies may replace general anesthesia for kids with cancer, and could be used for adults as well. Researchers are continuing with this study and plan to include adults who may be claustrophobic or anxious about their treatments.  While these children still did require some anesthesia, the amount was less which can ease the minds of parents and caregivers. If you or a loved one is preparing for a procedure, click here to visit our anesthesia information page to learn more.

    09 May
    09 May
  • Every year, millions of Americans are able to experience a painless surgery with the help of anesthesia, even though most don’t really know how anesthesia works. Each day, Steel City Anesthesia helps administer anesthesia to Ambulatory Surgery Centers, and hospitals and doctors’ offices across Pennsylvania, Ohio, and West Virginia. Although it is extremely common and vital to the world of medicine, there is constant research to find out exactly how anesthesia works. The most common theory is that anesthetics block neural function by disrupting fat molecules in the cell membranes. However, new research from a study done by Weill Cornell Medicine may have debunked a century-old theory of how anesthesia works. Co-researcher Dr. Hugh Hemmings, chair of the Department of Anesthesiology at Weill Cornell Medicine, discusses the new findings saying they have debunked a century-old theory of how anesthesia works and, “Finally have proof that these anesthetics must have a direct effect on integral membrane proteins – and not an indirect effect on proteins through the lipid bilayer – to put patients in a coma-like state, allowing them to undergo painful procedures with no memory or pain.” This new evidence supports the idea that anesthesia does not affect the lipid bilayer, which is the part of the cell membrane that is made up of fat. The new findings show rather than interacting indirectly through the membrane itself, anesthetics interact directly with membrane proteins, which inhibit electrical communications between neurons, which triggers unconsciousness. Researchers in this study reconstructed a model cell surrounded by thin membrane in order to determine the biological mechanism behind anesthesia. Thirteen different anesthetic agents were tested using a technique developed by by Dr. Olaf Andersen, a professor of physiology and biophysics at Weill Cornell Medicine, and Dr. Helgi Ingólfsson, Ph.D. The results showed that none of the anesthetics tested affected the lipid bilayer properties. “That was a very surprising result,” said Dr. Andersen. “When we started conducting the experiments I was convinced we would see some effect on the bilayer. The fact that the results are as clean as they are was to me really amazing.” While there is still more research to be done on this topic, these results are groundbreaking in the world of anesthesia. Researchers are always hoping to learn more, and this study may have just “debunked” a century old theory of how anesthesia works. As we focus on patient care and achieving industry leading satisfaction ratings,  having a better understanding of the mechanisms behind anesthesia can lead to the development of new anesthetic agents with less undesirable side effects.

    15 Mar
    15 Mar
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