Consciousness is Slightly Preserved During General Anesthesia
Orange County, CA - August 29th, 2018 - The first successful surgical procedure performed with Anesthesia was done by Dr. William T. G. Morton in October of 1846. Dr. Morton was an American dental surgeon who gained the medical world’s acceptance of surgical anesthesia, by doing a public demonstration of ether anesthesia. Since then, Anesthesia has continued to be administered to patients prior to surgery.
When a patient is administered with anesthetics, for the most part, they have lost all Consciousness. However, the rare phenomenon of anesthetic awareness affects 0.1 % of all general anesthesia patients. According to a group of doctors in Finland, when under anesthesia, we never lose consciousness completely; we are in an altered state similar to when we sleep. Two new studies published in the July issue of the British Journal of Anesthesia suggests the brain is still in a semi-conscious state.
"The state of consciousness induced by anesthetics can be similar to natural sleep. While sleeping, people dream and the brain observes the occurrences and stimuli in their environment subconsciously," explains Antti Revonsuo, a psychology professor at the University of Turku in Finland.
The study involved 47 participants that were anesthetized with either Propofol (a general anesthetic) or Dexmedetomidine (a sedative), with the attempt to wake them up. Researchers were able to easily gain back patients consciousness with a light shaking or a loud voice without changing the drug infusion. The group monitored the changes with an electroencephalogram (EEG). Once the subjects regained responsiveness, they were asked whether they experienced anything during the anesthesia period. Most of them reported experiencing dream-like experiences that were mixed in with reality.
The researchers played unpleasant sounds while the participants were under anesthesia, in the second study. Once they regained consciousness, they played some of the same sounds that had been played to them while under anesthesia. Participants reacted faster to the sounds that played while they were under anesthesia than the ones they hadn’t heard before. This suggests the brain is still processing sounds while under anesthesia.
“The brain can process sounds and words even though the subject did not recall it afterwards. Against common belief, anesthesia does not require a full loss of consciousness, as it is sufficient to just disconnect the patient from the environment” said Dr. Harry Scheinin, an anesthesiologist at the Terveystalo Pulssi Hospital and adjunct professor at the University of Turku, both in Finland.
The two studies gave participants light doses of anesthesia; researchers believe the results could also hold true for normal levels of anesthetics. “However, there are many other drugs that are thrown into the mix during normal surgery, including opioids and muscle relaxants, which could also alter the results,” Dr. Scheinin added.
All things considered, the information indicates that consciousness is not fully lost, even when the person is no longer reacting to their environment. While under anesthesia, the brain does not experience pain. Patients may experience dream-like thoughts, and the brain might try to register speech, but the person will not remember or understand them once they are awake. This new discovery could help further develop drugs or technologies eliminate unintended awareness.
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