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.
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.
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.
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.
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.
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.
Accurately assessing pain levels of a patient is always a challenge, and when the person is unable to communicate to describe the pain they are in, the challenge becomes even greater. Medasense Biometrics, Ltd. recently announced they have developed a pain monitoring device, the PMD200. This new device was created to help physicians in assessing pain levels of an individual when the patient is unable to communicate. This will assist anesthesia teams in providing the correct amount of pain-relief medicine based on accurately assessing pain levels of the patient. This device is based on the NOL technology, which quantifies an individual’s psychological response to pain. The PMD200 is a very easy to use system, which includes a finger probe that records psychological signals from four different sensors. The device also records dozens of pain-related psychological parameters. The data is then analyzed and converted into the Nociception Level index. In this index, 0 = no pain and 100 = extreme pain. This system will allow physicians to better manage pain treatments and help them avoid using too much or too little pain medicine. Too much pain medicine during a procedure can cause a patient to suffer from nausea, vomiting, respiratory depression, constipation, and hyperalgesia once they regain consciousness. Professor Albert Dahan, MD. PhD. from the Department of Anaesthesiology at Leiden University Medical Center in the Netherlands said, “We have been studying the PMD device for a number of years now, and I believe that the NOL index may allow for more balanced anesthesia, as for the first time we are able to titrate analgesic medication to patients’ needs. In the upcoming weeks, the LUMC will be adding PMD200 devices into the operating rooms. In the future, I hope to see the NOL index integrated into other monitors as it provides significant decision support information and can potentially positively impact patient outcomes.” The device is currently being distributed throughout Europe for use in operating rooms and in critical care units. The company also hopes to broaden the use of the NOL index and is currently researching other forms of pain such as chronic back pain. This device is a breakthrough in accurately assessing pain levels of a patient and can be a great asset to anesthesia teams in the future.
The thought of heading to the doctor for a procedure that requires local anesthesia probably doesn’t seem like that big of a deal. However, imagine if you were going to feel everything that was happening during the procedure. Well for some, this horrible nightmare is a reality. In very rare cases, some individuals have a resistance to local anesthesia, and no matter the amount received, they can still feel pain. In a report from the BBC, a woman named Lori Lemon, discusses how since she was young she has always had to go to the dentist and other doctors expecting to endure pain. Even after crying out during dental procedures, doctors never took Lori seriously. She describes a visit to the dentist as a young child when her condition first became apparent, “They started working on me and I, being obedient, I just raised my hand and let ’em know, ‘I can feel this’,” she says. Another injection still proved that she had a resistance to local anesthesia. “Finally I just kind of screamed and was in tears the whole time.” When she recently visited the Mayo Clinic in Jacksonville for a procedure to remove a lipoma from her elbow, an anesthesiologist noticed that none of their methods were working and knew something had to be wrong. Dr. Steven Clendenen, the anesthesiologist at the clinic, said “The nerves were flooded with local anaesthetic and at the time it didn’t work.” Clendenen decided to research this issue further and found that while there were other cases of this same problem, there was hardly any answers as to why patients had a resistance to local anesthesia. After finding out Lemon’s mother and maternal half-sister also suffer from a similar type of resistance to local anesthesia, he decided to do a genetic study on the family. Doctors discovered a genetic defect which was directly related to a specific sodium channel in the body, sodium 1.5. “We looked at the genetics of that and went, ‘wow’ – [her mother] had the same gene defect,” explains Clendenen. This genetic mutation is significant due to the theory that local anesthetics are successful due to the disruption of sodium channels. Since sodium 1.5 channels have mostly been studied in heart tissue, not the peripheral nerves where local anaesthetic is applied, there is still a lot of research that needs to be done. “This is really important to get that out there,” said Clendenen. “People don’t believe [these patients] and it’s very frustrating. Even some of my colleagues that I’ve talked to say, ‘I don’t believe it’.” For patients like Lori Lemon, however, this has put light on the issue and gives them some relief knowing there is work being done to figure out this problem. If you or a loved one is preparing for a procedure, click here to visit our anesthesia information page to learn more.
There is often still concern about the later effects anesthesia may have on a person, especially anesthesia on toddlers. There have been numerous small studies done analyzing the effects, if any, that may appear later in a patient’s life. Results of a recent study in Sweden, the largest of its kind, suggest anesthesia on toddlers carries no long term risks. Patients who have anesthesia before age 4 show little risks later in life, especially for intelligence. Overview of Anesthesia on Toddlers Study The results of this study were based on research done on 200,000 Swedish teenagers. 33,500 of these teenagers had been exposed to anesthesia before the age of 4 and nearly 160,000 of the teenagers had never been exposed to anesthesia. The school grades of the teenagers at age 16 were on average less than a half a percent lower in teenagers who had undergone a childhood surgery than the teens who had not had surgery. Among teenagers that had two or more surgeries, grades were less than two percent lower. IQ tests were also given to boys in the study who were 18 years of age. IQ scores were nearly the same among all tested. The leader of this study, Dr. Pia Glatz from Sweden’s Karolinska Institute, as well as other researches mentioned that other factors, a Mother’s education level for example, pose more of a risk on intelligence than administering anesthesia on toddlers. Among those studied, the most common surgeries the teenagers had received as children were hernia repairs, abdominal procedures, and ear, nose, or throat operations. These surgeries likely caused the children to be under anesthesia for about an hour or less. Researchers involved in the study as well as other physicians find the results of this study reassuring, and believe parents need to consider the harm of postponing surgery more than future risks for intelligence and academics later in life. A journal editorial says the study is “reassuring for children, parents and caregivers and puts the issue of anesthetic-related neurotoxicity and the developing brain into perspective.” While this study is still ongoing, it can put parents and caregivers at ease knowing that this study shows anesthesia on toddlers carries no long term risks. If you or someone you know wants to learn more about anesthesia before a procedure, take a look at our surgery patient FAQ page.
It is pretty fair to say that no one really enjoys getting a cavity filled or going under anesthesia because of a painful surgery, it’s just something we have to do. Although it isn’t fun for anyone, redheads may dread a trip to the dentist’s office a bit more than the average person, and for good reason. Over the years, many have said that a patient’s natural hair color may have an impact on anesthesia efforts. But do redheads really require more anesthesia? Recent studies have been done that show people with naturally red hair often require a higher dosage of anesthesia, and are sometimes resistant to pain blockers, such as novocaine, than their brunette or blonde counterparts. Making up only 1-2% of the population worldwide, the genetics of a redhead are what makes them such a rarity. Researchers believe a mutation of the gene that causes people to have red hair and fair skin, also has an effect on a person’s sensitivity to pain. The Mc1R gene, which affects hair color, produces melanin in people with blond, black, or brown hair, but a mutation causes it to produce pheomelanin in redheads. This gene is a part of a family of receptors in the brain that include pain receptors, which may be why it affects a redheads tolerance of pain. Dr. Daniel I. Sessler, an anesthesiologist and chairman of the department of outcomes research at the Cleveland Clinic, said he started studying hair color after hearing many colleagues discuss redheads needing more anesthesia than patients with different hair colors. “The reason we studied redheads in the beginning, it was essentially an urban legend in the anesthesia community saying redheads were difficult to anesthetize,” Dr. Sessler said. “This was so intriguing we went ahead and studied it. Redheads really do require more anesthesia, and by a clinically important amount.” Researchers believe patients with red hair require about 20% more general anesthesia than the average person, which proves that redheads being harder to anesthetize was not just a myth in the medical community. Another study in 2005, proved that redheads are more resistant to the effects of local anesthesia, such as the numbing drugs that are often used by dentists. It is possible that people with dark skin, eyes, and hair may produce more melanin than normal and in turn will also require more anesthesia. So the next time you hear your redheaded friend complaining about a routine trip to the dentist, you’ll know why!
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