New research supports earlier findings that indicate that anesthesia is no more hazardous for the brain at higher doses than at lower doses.
General anesthesia makes it possible for millions of patients each year to undergo lifesaving surgeries while unconscious and free of pain. But the 176-year-old medical staple uses powerful drugs that have stoked fears of adverse effects on the brain -- particularly if used in high doses.however, support an earlier study that indicates that anesthesia is no more hazardous for the brain at higher doses than at lower doses, according to the researchers.
The dose of administered anesthesia historically has been a carefully calculated balance between too little and too much. Administering an inadequate amount puts patients at risk of experiencing intraoperative awareness. Despite advances in anesthesia care, about 1 in 1,000 people still experience unintended waking during surgery without being able to move or indicate their pain or distress. This can lead to suffering and lifelong emotional trauma.
To study the impact of minimizing anesthesia on postoperative delirium, Avidan and colleagues previously conducted a similar clinical study in more than 1,200 older surgical patients at Barnes-Jewish Hospital in St. Louis. The researchers used an electroencephalogram to monitor electrical activity in the brains of patients during major surgery and adjusted anesthesia levels to prevent brain activity suppression, considered a sign of excessive anesthesia levels.
"The thinking has been that deep general anesthesia excessively suppresses electrical brain activity and causes postoperative delirium," Avidan said."Taken together, our two clinical trials, including almost 2,400 high-risk older surgical patients at five hospitals in the United States and Canada, dispel the concern that higher general anesthetic dosing incurs a neurotoxic cost.
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