Being “conscious” under anesthesia may be more common than we think

General anesthesia is a wonderful thing, it stops the pain in a few seconds before the operation.

Rarely, however, do some people respond to the environment under general anesthesia but cannot remember what happened next.

This is called “connected consciousness,” and the largest study of this phenomenon to date shows that it is more common than it first thought, affecting 1 in 10 people and women more than men.

Researchers say the results show a need to better understand how different people respond to anesthetics. Although used for 170 years, we still do not fully understand how general anesthesia works – now age and gender seem to have become another factor in the mix.

Robert Sanders, an anesthesiologist and neurobiologist at the University of Sydney in Australia, said there was an urgent need for additional research into biological differences, especially gender, affecting susceptibility to anesthetics.

If the results of the new study are to be repeated, it could bring us one step closer to understanding who is more likely to experience “connected consciousness” and how anesthesiologists can reduce it.

Previous estimates estimate that about 5 percent of people under general anesthesia experience “connected consciousness.” However, Sanders’s team relied on other studies to suspect that it was more common in young people.

The results of a new study show that more young people are still responding under general anesthesia before surgery begins.

Of the 338 young people aged 18 to 40 who participated in the study, about 10 responded to requests to squeeze the researchers’ hands once if they understood, and twice if they were under general anesthesia.

An hour after waking up, participants were asked to recall 16 words they had heard under anesthesia and to see what they remembered from the incident.

Studies show that women experience two to three times more “connected consciousness” than men.

If a continuous level of anesthesia was maintained for a few minutes after anesthesia and before intubation, there was a low probability of “connected consciousness” at the site of insertion of a plastic tube into the human trachea to maintain airflow during delivery and delivery of anesthetics. .

It should be noted that a smaller proportion of people with “connected consciousness” – only 0.1 percent – experienced it during anesthesia, after which they were able to remember specific details about the procedure.

In this case, “connected” means that the areas of the brain that are able to process emotions are partially focused, but not fully aware.

“Patients lose consciousness under anesthesia and wait to get sick, and this study of anesthesia shows why it is so important,” Sanders said.

Approximately 13 percent of the women in the study responded to anesthesia orders, and compared to 6 percent of men, they received the same amount of propofol used to initiate and maintain general anesthesia.

“If there are, the differences in dosage are small and do not explain why women feel more connected consciousness than men,” the researchers wrote in their articles.

About half of the 37 people who responded to the orders said they were ill and would be treated immediately by adjusting the dose of anesthetic drugs. One person also clearly remembered the surgical experience after the procedure.

“In our opinion, this is a higher level of consciousness than patients (or their anesthesiologists) expected during general anesthesia,” Sanders and colleagues wrote in the newspaper.

It may seem that these anesthetics have knocked us down before we can count to ten. .

However, this seems to be a very good line for anesthesiologists and varies greatly from person to person.

At least now, anesthesiologists can better understand how regular anesthesia for the first few minutes (a standard practice in many countries) can help reduce the onset of “connected consciousness.”

“It’s important to note that patients couldn’t remember to respond to orders,” Sanders said, adding that general anesthesia was generally very safe.

“If anesthesia medications are given regularly between the anesthesia induction and intubation, the risk of connected consciousness is significantly reduced,” he said.

Published in a research journal British Journal of Anesthesia.


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