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!
Each year, millions of Americans safely and successfully undergo procedures while under a form of anesthesia. While it is extremely common to require anesthesia for a surgery, most patients don’t really know much about the anesthetic itself. As we approach the 170th anniversary of the first successful use of a form of anesthesia, here are four interesting facts about anesthesia you may not have known. Before Anesthesia, Patients were Told to “Bite the bullet.” This popular phrase has meaning that dates back to a time before there was anesthesia. A wounded patient, often a soldier, would be told to “bite the bullet” while enduring painful surgery without anesthetic. Aside from bullets, patients were often given sticks, leather straps, and other objects to clench between their jaw during painful procedures. As you can imagine, this was not a very good alternative to anesthesia, and we are very thankful so much has changed! Anesthesia Causes Temporary Amnesia Anesthesia activates memory-loss receptors in the brain, which ensures the patient has no memory of the surgery. Some look at the effects of anesthesia as just being “put to sleep”, but this really is not the case considering if it was just sleep, the patient would be awakened by the extreme pain their body is experiencing. The effects of anesthesia can be more closely related to a reversible coma than to a deep sleep. Smokers May Need Higher Doses of Anesthesia than Nonsmokers Smokers, as well as people who are regularly exposed to secondhand smoke, may require more anesthesia than the average non-smoker. A study monitored a group of women all undergoing the same surgery. The results of the study showed the women who were smokers required 33% more anesthesia, and women exposed to secondhand smoke required 20% more. John Reynolds, MD, an associate professor at Wake Forest University, says smokers have irritated airways, and as a result, they may need higher doses of pain medication to improve their tolerance with the breathing tubes. Redheads May Sometimes Require More Anesthesia Due to a gene that causes their red hair, redheads sometimes require 20% more anesthesia than the average patient. This gene is known as the melanocortin-1 receptor (MC1R) and responsible for the bodies pigment. The MC1R gene is also connected to hormones that stimulate pain receptors in the brain. The gene can sometimes overproduce a pain-related hormone, which may make redheads more sensitive to pain, in turn causing them to require more anesthesia. While anesthesia has been around for some time and has become extremely common in the world of medicine, there is still a lot of interesting facts about anesthesia that many people do not know. We hope you enjoyed learning some interesting facts about anesthesia and, if it peaked your curiosity in learning more about anesthesia, CLICK HERE for some Frequently Asked Questions and Answers from Steel City Anesthesia.
Viral videos are constantly popping up, and it seems like every week there is a new video circulating the internet. Many times, anesthesia is the source of the hilarity in these viral sensations. We’ve all seen videos of patients waking up after a procedure, saying outlandish things while their family members get it all on film. Who can forget the girl who took a ride on a unicorn? One of the first, with 1.3 million views on YouTube, is the little boy who became known as “David After the Dentist”. The adorable little boy keeps asking “Is this real life?”, and telling his Father “I feel funny!”. While it is obviously the anesthesia that makes the stars of these videos say some interesting things, many people wonder what exactly the anesthesia does to put patients in this confused state of mind. Anesthesia affects all patients differently, and often times it causes them to say strange things and act differently than they normally would. The word anesthesia is derived from greek and actually means “loss of sensation”. It is administered to patients to relieve pain, paralyze muscles, and encourage amnesia so the patient undergoing the surgery has no memory of the procedure. Anesthesia temporarily disrupts normal brain function, which may be why many patients wake up feeling scared, anxious, or saying funny things they would not normally say. The effects are often compared to a very deep sleep, however, the effects of anesthesia are more closely related to a reversible coma. The dosage of anesthesia given to a person is very carefully controlled. The process is closely monitored by highly skilled professionals like the medical professionals at Steel City Anesthesia. We can confidently say the patients will be in great hands during the procedure, but if they wake up saying hilarious things, we can’t guarantee their family and loved ones won’t have their cameras ready! For more information or questions about what you or a loved one might experience with anesthesia, CLICK HERE for some Frequently Asked Questions and Answers from Steel City Anesthesia.
New laws and changes in legislature are common and affect many different things, including the world of healthcare. Medical professionals are required to make changes and adapt as needed to make sure they are following the laws and guidelines. Recently, a new law in Utah has passed that is causing conflict between medical professionals and the government. The bill, recently signed, is the first of its kind. This new law requires anesthesia for abortions past 20 weeks to be administered by doctors to patients to eliminate pain for the fetus. Whether or not a fetus can feel pain at that state remains to be a controversial topic, and many doctors and medical professionals have varying opinions. “If a child can experience pain, we have an obligation to protect that child,” said Republican state Sen. Curt Bramble, who sponsored the law. Bramble originally hoped to ban all abortions after 20 weeks but abandoned the idea after legislative attorneys warned him it would likely be unconstitutional. Many agree that the fetus will feel some degree of pain and hope that this law will change that while protecting the fetus. While many support this law, many doctors disagree and are fighting back. Doctors are uniting across the country and are concerned if a law requires anesthesia for abortions, the use of anesthesia or painkillers may increase health risks for women by giving them heavy sedation. Some believe it is unnecessary and not healthy for the woman. Dr. Leah Torres, a Salt Lake City obstetrician-gynecologist claims to be confused by the law and says “I have no choice but to cross my fingers and hope that what I’m doing already is in compliance, because I don’t know what they’re talking about,” With the subject of fetal pain still being a very controversial topic, people can argue which side is right and wrong. Regardless of what a doctor or medical professional may believe, the bill passed and changes will now have to be made as this law requires anesthesia for abortions. With further research and tests, hopefully more information will be available on this controversial and important topic.
In a previous blog post, the idea of machines taking over the job of an anesthesiologist was discussed. Although we believed this was far off, a few new machines were beginning to gain popularity in the medical world. Just recently, however, sales of the Sedasy machine, made by Johnson & Johnson, have been stopped. Johnson & Johnson says halted sales are due to poor sales and cost cuts within the company which means the concept of facilities using machines over anesthesiologists is still far off. To refresh your memory, the most popular of these devices is called Sedasys, an open-loop system that can administer the initial dose of anesthesia a patient needs, favoring machines over anesthesiologists. The machine was developed to be used for patients undergoing endoscopies and colonoscopies. The dosage of medicine is predetermined by the patient’s weight and age, and the machine can reduce or stop drug delivery depending on the patient’s condition. The machine, however, cannot decide alone how much anesthesia the patient needs, and the dosage can only be increased by the doctor or nurse that is monitoring in case of emergencies. This more conservative approach is what offered comfort to regulators and helped win the approval of the FDA. Johnson & Johnson believed, at first, that the Sedasys system would be a cost efficient way to administer anesthesia, but the machine was quickly fought against by many medical professionals, especially anesthesiologists. Many were concerned that choosing machines over anesthesiologists would begin a less humanistic approach, which many people did not like. Safety concerns were also an issue. “While the Sedasys System can safely administer sedation for healthy patients undergoing the procedures mentioned, emergencies can and do occur, even during the simplest procedures and with the healthiest patients,” Jeffrey Apfelbaum, co-chair of the ASA committee on the Sedasys machine, said in a 2015 interview with Medscape. “Additionally, many have concerns for the safety of patients if device operators do not remain in strict compliance with the limitations imposed by the FDA on the use of the device.” While choosing the Sedasys machine over anesthesiologists is no longer an option as they are no longer being produced or sold, there are still others on the market, and new machines may begin to pop up. However, it still seems that something like this will never be accepted universally by medical professionals. As the fastest growing Anesthesia Management Solution in the midwest, Steel City Anesthesia offers more than just anesthesia services. We strive to provide exceptional patient satisfaction and meet anesthesia needs with a personal touch that will never be able to be replaced by a machine.
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