Under Anesthesia, Where Do Our Minds Go? - Deepstash
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General anaesthesia redefined surgery

General anaesthesia redefined surgery

Dentist William Morton performed the first successful public test of a general anaesthetic in 1846. He first experimented on a hen, his dog, his goldfish, and himself before going to the Massachusetts General Hospital surgical theatre.

His concoction of sulfuric ether and oil from an orange (just for the fragrance) knocked a young man unconscious while a surgeon cut a tumour from his neck.

Today’s anaesthetic includes ether-based inhalants such as sevoflurane and isoflurane, and intravenous anaesthetic propofol.


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Risks with general anaesthesia

General anaesthesia redefined surgery and medicine, but over a century later it still carries significant risks.

  • Too much sedation can lead to neurocognitive disorders and may even shorten lifespan;
  • Too little can lead to traumatic and painful wakefulness during surgery.

Generally speaking, anaesthetic drugs render people unconscious by changing how parts of the brain communicate. But scientists still don’t fully understand why.


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Negative effects of anaesthetic

Negative effects of anaesthetic

  • 17 to 43 percent of patients may have cognitive problems such as memory and executive functions that typically last for up to two weeks. However, delirium in adults over 65 can last for several months.
  • Some studies have shown that the risk of long-term cognitive damage and post-op delirium is highest for those who already have underlying cognitive vulnerabilities, such as Alzheimer’s or mild cognitive impairment.
  • A small percentage of patients have reported traumas from recalling some experience of their medical procedure during general anaesthesia.


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Signal to noise

In 2011, renowned anesthesiologist Emery Brown began using EEG to track patients’ brain waves.EEG records the electrochemical activity between communicating neurons in the brain. 

During general anaesthesia, you can see, based on the patterns on the EEG monitor, how unconscious someone is, and you can dose your drugs accordingly. But testing whether EEG monitoring helps patients go under and recover better has produced mixed results.


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Usefulness of anaesthesia

Usefulness of anaesthesia

Understanding how patients wake from anaesthesia and under what circumstances they struggle could also help scientists with how to treat disorders of consciousness, including coma. 

Researchers can use general anaesthesia to control the transition into and out of unconsciousness. Like anaesthesia, a coma seems to alter essential communication between different brain networks.

Researchers already use anaesthesia to test potential coma therapies. For example, Ritalin, often prescribed for ADHD, has been found to bring rats back to consciousness after general anaesthesia.


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