Postoperative delirium is a state of agitation or confusion in the days following a procedure involving anesthesia. It is most common in older patients, with nearly 25% of them experiencing this unpleasant event after surgery. In the past, researchers believed that very closely monitoring the brain of older patients during surgery, and reducing the amount of anesthesia used would prevent the confusion following a procedure. However, a new study suggests this is not the case and that less anesthesia during surgery does not prevent postoperative delirium. Researchers from Washington University School of Medicine, studied 1,200 older patients undergoing surgery at the Barnes-Jewish Hospital in St. Louis, Missouri. Half of the patients were randomly selected to receive normal care during their procedure while the other half received very close and meticulous monitoring of brain activity measured by a electroencephalogram. The results showed that 23% of the patients that received normal care and monitoring suffered from postoperative delirium, and 26% of the patients that were closely monitored also suffered from the same delirium in the days after their surgery. “The thought has been that at certain levels of anesthesia, brain activity is suppressed, and that is what mediates these problems,” said first author Troy S. Wildes, MD, an associate professor of anesthesiology. “But we found that preventing suppression by closely monitoring and then adjusting doses of anesthesia made delirium no less likely.” The study did find that there were fewer deaths in the month after surgery among those who had their brain activity closely monitored as compared to those who did not. In those that had been monitored, less than 1% passed away within a month, while in the other group, 3% of the patients passed away within 30 days of their surgery. The Principal investigator Michael S. Avidan, MBBCh, the Dr. Seymour and Rose T. Brown Professor of Anesthesiology said “I believe we should monitor the brain of every single patient during general anesthesia, just as we routinely monitor heart and lung function,” Avidan said. “Monitoring other organs during surgery has become the standard of care, but for some reason, even though the brain is the target of anesthesia drugs, this type of close monitoring and adjustment has never become routine.”While these findings show less anesthesia during surgery does not prevent postoperative delirium postoperative, it did discover other findings that will be further researched. For more information on anesthesia, visit our website www.steelcityanesthesia.com.
Having a young child with any type of health problem or illness can be very stressful for parents and family members that are required to make important decisions on the behalf of the child. As if the stress of the health condition is not enough, parents also worry that a procedure requiring their child to be put under anesthesia can have negative effects on them later in life. People often worry anesthesia can cause developmental problems that will affect their child’s readiness for school and cognitive problems. A recent study, however, may prove that anesthesia in young children is not linked to developmental problems The study, performed in Canada, examined research on 11,000 pairs of siblings, 370 of which both siblings had been exposed to general anesthesia at a young age, and about 2,350 pairs of which only one sibling had ever been exposed to general anesthesia. The most common procedures that the children had had were related to ears, mouth, and throat or the musculoskeletal system. Researchers for the study examined data collected from teachers that accessed the development of the children before they started school at the age of five or six. The study did not show a link between developmental problems and children that were exposed to anesthesia. Young children that had been under anesthesia due to a procedure, were no more likely than their sibling to experience any issues, developmentally. Some children that were exposed to anesthesia did have a slightly higher risk of developing health problems and other issues compared to their siblings, but the difference were so small, researchers could not say this was due to chance. “This study adds to the increasing data that for the vast majority of cases anesthesia does not have an impact on school readiness and this should be added to the fact that we increasingly think in the majority of cases it does not have an impact on cognition and many other aspects of neurodevelopment,” said Dr. Andrew Davidson of Royal Children’s Hospital and the Murdoch Children’s Research Institute in Melbourne, Australia. “The findings of the current study should reassure parents of young children who require anesthesia for surgical procedures,” said lead author Dr. James D. O’Leary. Knowing that anesthesia in young children is not linked to developmental problems should give parents and family members some peace of mind when making decisions regarding the health of their children. The pros of surgery under anesthesia outweigh the cons. If someone you know is looking to learn more about anesthesia and how to prepare for a surgery, visit our website at www.steelcityanesthesia.com.
Without the advancements and developments in anesthesia since its first use in 1846, many modern procedures and surgeries would not be possible. By eliminating pain, surgeons are able to perform otherwise extremely painful surgeries on patients in need. Although anesthesia is extremely common and necessary for many surgeries, patients are still sometimes apprehensive about “going under”. By explaining the three types of anesthesia, we hope to ease the minds of patients who may be preparing to undergo a surgery that requires some type of anesthesia. Local Anesthesia Local anesthesia is typically used for minor procedures where the physician does not need the patient to be unconscious for the surgery. It is used to block the nerves in one specific part of the body without affecting any other area. For example, if someone was receiving certain types of dental surgery, a local anesthetic would be used just to numb that area of the mouth, but would not affect the rest of the body. Local anesthesia can be administered in the form of an injection, or topically with a spray or ointment. This type of anesthesia usually starts to work within a few minutes and wears off after a few hours. While the patient will not feel pain during the procedure, they may feel slight pressure in the area. Regional Anesthesia Regional anesthesia is used to numb larger parts of the body during more invasive procedures, but the patient is still not unconscious. It is most commonly used for surgeries on the lower body, such as cesarean sections or surgery on the legs. Different types of regional anesthesia include spinal anesthesia, epidural anesthesia, and nerve blocks. Regional anesthesia may be administered with a needle or a catheter line which allows anesthetics and other medications can be administered throughout the procedure. This type of anesthesia is typically used when long term pain relief is needed. General Anesthesia General anesthesia is the type where the patient is put completely to sleep. This allows the surgeon to operate without any interruption, and keeps the patient from feeling any pain or having any memory of the procedure. This is used for surgeries that cannot be done with the patient being conscious. General anesthesia is typically inhaled through a breathing mask or given intravenously. During the procedure, patients are closely monitored by their anesthesiologist to make sure heart rate, blood pressure, and blood oxygen levels are regulated. The anesthesiologist also carefully controls and adjusts the amount of anesthesia given throughout the surgery. The three types of anesthesia are extremely helpful in successfully operating on patients undergoing surgeries of all kinds. By understanding each type, patients can have peace of mind knowing which type of anesthesia they are receiving and why. If you or a loved one is preparing for a procedure that requires anesthesia, visit our page that discusses anesthesia information for surgery patients.
For over 170 years, doctors have been using many different forms of anesthesia to make patients unconscious when it is necessary for surgery. Millions of Americans receive anesthesia every year, and it is now a very common part of surgery. While it is a very common practice, many people still wonder about the effects of anesthesia on the mind and body. The truth is, all of the details of exactly how the process works is unknown, but more is being discovered about the effects of anesthesia on the mind and body with each new study. In an article from Business Insider, Anesthesiologist Jill Fong explains how anesthesia interrupts the brain’s neural pathways so patients don’t feel pain during a procedure. She discusses how for anesthesia to work correctly, you need amnesia so the patient does not remember anything from the surgery and analgesia so the patient has pain relief. Depending on the type of surgery and the operating conditions, some patients may also be given muscle relaxers to keep their body relaxed, while others may be given medication to suppress excitatory neurons or enhance inhibitory neurons. The article explains “Excitatory neurons, for example, get excited and send signals to other neurons to fire. Depressing them means less signals telling your brain you’re in pain. Inhibitory neurons do the opposite. They make it harder for neurons to generate these electrical signals. In either case this means fewer active neurons overall which is important because when your body is being poked and prodded, neurons would typically fire to tell your brain you’re in pain. If those neurons aren’t firing, your brain doesn’t know that your body is, well, being cut open.” The pathways and communication between your neural networks are interrupted, which leaves the body unconscious, and unable to feel or remember a surgery. Identifying the effects of anesthesia on the mind and body is sometimes tough to determine, considering all of the advancements which have been made since its first use in 1846. Without the advancements in anesthesia, we would not have the advancements in surgery. Countless studies and immense research is helping us understand exactly how anesthesia works, and if necessary how it can be improved. For more information on anesthesia, visit our website at www.steelcityanesthesia.com.
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.
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.