Anaesthesiological Neuropathogenisis: Sleep To Be Mindful Of?

[Ermintruder]

This is a topic that as far as I can tell has not been discussed previously on FTMB (according to my search/checks). If I'm wrong, please move/append this thread accordingly.

Ok....

I heard about this in a UK radio news item about 18 months ago, and at the time I was utterly-shocked by what I heard: that the application of general anaesthetics has been shown to produce irreversable damage to mental processes in the very young and the fairly old.

I was so shocked by this, that perhaps I blanked it out from my memory, since it seemed to be such a cruel and inescapable aspect to what is an essential aspect of medical surgery.

Recently (late summer last year) the whole story began to resurface into my consciousness- a distant elderly relation was about to undergo some surgery. Whilst being unaware of having seen any further media mention of this anaesthetic downside myself since (say) summer 2014 (but believing to be in possession of a valid, revised, appreciation of a hitherto-unknown facet of risk) I sensitively raised the topic with the more immediate family members of the impending patient.

I was immediately rejected as being a paranoid fantasist (or worse) and accused of raising utterly unheard of fictional concerns.

Backing off rapidly, I cautiously spoke with a few work colleagues who expressed similar (though more objective) levels of utter disbelief in my conversational concerns, showing no awareness whatsoever of this having been ever mentioned in the press/media....at all.

I began to almost doubt myself, starting to think along the lines of false memory syndrome, even perhaps a touch of parallel universe dislocation (cf http://mandelaeffect.com)

So it was very nearly with some relief that I stumbled across this depressing article tonight:

http://www.dailymail.co.uk/health/article-2748255/General-anaesthetics-harm-young-children.html

The frightening recollection I had of the original concerns, as reported, reproduced pretty much as I remembered it.

So let's cut to the chase- and this is important

- did you genuinely know about this alleged bad effect that may result from general anaesthesia?

- have you always known about it?

- or, did you only find-out about it, right now, by reading this post?

- (alternatively...) did you find-out about it roughly when I did, back late in 2014?

- if so, have I just been oddly/personally oblivious to any media updates/discussions on this matter? Has it been getting discussed online/ in the press? Or has there been a virtual silence about it?

I've absolutely no wish to scare people, ever, about anything.

Sorry, I should've added the prefix 'unnecessarily' in the preceding sentence.

Your comments/thoughts on this?

Please.

 

[Mythopoeika]

I found out about it a few years ago.
I had a minor procedure where they knocked me out to stick a camera up my urethra into my bladder.
Beforehand, just before they administered the anaesthetic, they asked me what I did for a living.
When I came to, they asked me my name and what I did for a living.
Baffled for some time after, I found out about people having problems and adverse reactions to general anaesthetics.
I also found out that surgeons tend to prefer local anaesthetics if they can get away with it.
How people react to these things can depend a lot on each patient's level of fitness.

 

[Coal]

Didn't know, but faintly alarmed as the youngest Coalette was given a general when she was around 10, the only time.

Well picked up.

The article talks of a correlation only mind, no causal mechanism. It might be that children pre-disposed to learning difficulties are more like to have accidents or have other heath issues for example. Having said that, it's a worrying thing.

 

[Ermintruder]

@Mythopoeika, for sure, I appreciate that some people can have bad reactions to anaesthetics, and I believe that's part of the shared lay understanding. Indeed, perhaps there's also a tacit acceptance that in (for example) 100,000 cases, one person might not wake up at all, following a general anaesthetic.

But surely that's a long way off from a formal recognition that ADHD/IQ reduction/dementia may be catalysed, predictably, as a consequence of the standard use of general anaesthetics?

EDIT @Coal - I understood from the radio coverage that it was very close to being causal. I do concede, I was reading the Daily Wail article in that vein (no pun)

 

[David Plankton]

or, did you only find-out about it, right now, by reading this post?

This one.

 

[Monstrosa]

By reading your post.

 

[Ulalume]

Hmm. I can't quite select from the exact options you've given, because while I have always known of problems with anethesia, it's not exactly in the terms you've described.

First, I was born to an older family, with a number of relatives who'd had surgery in the days when anethesia was highly dangerous, before oxygen-satuation monitoring was invented...so I'd heard "stories"

Second, having noted prolonged mental changes in relatives after a surgery, and being told that was "normal" by the doctors. This didn't happen in every case, mind you, only some, but enought to have filed it away in my mind as a risk.

Third, I've heard people tell of other strange effects of anethesia - for instance, several women i've known insist that their hair would no longer grow past a certain length after they'd had a c-section. I asked a relative who is a retired nurse about this, and she said that she didn't doubt it, as she'd seen anethesia have all sorts of strange effects on people after the fact.

So, basically, I've always known about risks/effects, but it comes more from personal and family experiences than medical literature.

 

[Mythopoeika]

Third, I've heard people tell of other strange effects of anethesia - for instance, several women i've known insist that their hair would no longer grow past a certain length after they'd had a c-section. I asked a relative who is a retired nurse about this, and she said that she didn't doubt it, as she'd seen anethesia have all sorts of strange effects on people after the fact.

Hmmm.
I wonder if that's why my hair has thinned in recent years.

 

[Shady]

Ive never heard of it till now.
Ive only ever had one op and when i came to i was crying, when they asked why i said i dont know why, and after i was put back on the ward a while later i projectile vomited, also i would tear up at the slightest thing

 

[Novena]

Ive never heard of it till now.
Ive only ever had one op and when i came to i was crying, when they asked why i said i dont know why, and after i was put back on the ward a while later i projectile vomited, also i would tear up at the slightest thing

I was told that it's quite common to feel intensely depressed and tearful after anaesthesia, so it sounds like your experience wasn't unusual, @Shady, although obviously distressing for you at the time.

This thread interested me, as I've just undergone my first ever general anaesthetic. However, I have felt very few ill-effects from it. Apart from some initial blurred vision and some mild nausea, both of which soon dissipated, I haven't noted any other effects, mental or physical. Clearly the very young and the very elderly are more vulnerable and thus predisposed to have more problems afterwards (and I would also note that the Daily Mail is not often known for its sober, factual reportage... ) so I suspect as @Coal says, there is probably correlation not a causal link. Medical practitioners do take great care to warn you that there are risks with anaesthesia (including death ) but I suspect there is still very little danger involved if you are in otherwise good health. I think it also depends how long you are 'under' - the less time, the fewer ill effects, I suspect.

I did briefly recall about those (possibly apocryphal) stories of people 'waking up' mid-operation, unable to move or speak and in terrible agony... but then I decided it would be better to definitely NOT think about that...

 

[Schrodinger's Zebra]

So let's cut to the chase- and this is important

- did you genuinely know about this alleged bad effect that may result from general anaesthesia?

- have you always known about it?

- or, did you only find-out about it, right now, by reading this post?

- (alternatively...) did you find-out about it roughly when I did, back late in 2014?

- if so, have I just been oddly/personally oblivious to any media updates/discussions on this matter? Has it been getting discussed online/ in the press? Or has there been a virtual silence about it?

I've absolutely no wish to scare people, ever, about anything.

Sorry, I should've added the prefix 'unnecessarily' in the preceding sentence.

Your comments/thoughts on this?

Please.

Prior to the beginning of this year I was not aware of the risk you've mentioned, had not heard about it in the media - it certainly isn't talked about so I'd say yes, there is a virtual silence about it (even now, two years since your post!)

I became aware early this year, when I was reading up about general anaesthetics in preparation for a procedure (a test, basically) I had done in February.

I definitely think it should be something that patients are made more aware of - so they could at least try to take steps to mitigate it just in case (keep their mind more active with puzzles, etc? things like that? perhaps encourage the patient to do crosswords while they're recovering?)

It's good that you've brought it to some attention here though Ermintruder - anything that gets the word out, etc.

Ive never heard of it till now.
Ive only ever had one op and when i came to i was crying, when they asked why i said i dont know why, and after i was put back on the ward a while later i projectile vomited, also i would tear up at the slightest thing

Sorry to hear you went through that I've heard that it can be to do with all the anxiety that a patient couldn't release while they were 'under' comes out when they wake up (or summat like that ) - I'm not sure about that but I do know that anxiety can manifest itself in peculiar ways after anaesthetic.

 

[Ermintruder]

it certainly isn't talked about so I'd say yes, there is a virtual silence about it

A frustrating aspect is that I've raised this possible situation with a few close friends that are medical professionals, and their reactions are interesting (where 'interesting' is a euphemism for "worrying-but-intriguing"). They tend to become oddly non-scientific (I'll come back to that) and firmly fall to the shaky back-foot of statistical probabilities, matrix-multiplied by relativities-of-risk

Being surgically-operated upon under general anaesthetic for potentially-fatal conditions, versus just dieing, presents a no-contest selection to the sufferer.

But (notwithstanding my instinctive doubt regarding the veracity of everything...excepting birth, death and taxes) there is an emergent point, here. Has there actually ever been a proper pathological study of the after-effects of anaesthesia? I must ask this question (unfortunately, a special secret part of the Hippocratic Oath means not only would such a query be laughed to scorn, it pigeon-holes you as a DNO patient ('Do Not Operate'). Seriously. If I were a surgeon, and my patient came out with this question, I'd avoid operating on them like furio. And I might even try, actively, to drop such a patient off my practise.

 

[Schrodinger's Zebra]

A frustrating aspect is that I've raised this possible situation with a few close friends that are medical professionals, and their reactions are interesting (where 'interesting' is a
euphemism for "worrying-but-intriguing"). They tend to become oddly non-scientific (I'll come back to that) and firmly fall to the shaky back-foot of statistical probabilities, matrix-multiplied by relativities-of-risk

I can think of two possible reasons:
I know through personal experience that medical professionals do not like being questioned and do not like patients acting like they know more than them. I'd be inclined to ascribe this to your experience, but for the fact that they are close friends of yours.
So, the alternative explanation is that they are fully aware that what you are asking them about is a genuine problem but are unable to say this to the public at-large (whether friends or not).

But (notwithstanding my instinctive doubt regarding the veracity of everything...excepting birth, death and taxes) there is an emergent point, here. Has there actually ever been a proper pathological study of the after-effects of anaesthesia?

I am beginning to have the distinct worry that the answer to your question is no, or at least not since they first developed anaesthesia (one would hope they studied it then) -

- because medical professionals are always so quick to tell us that such-and-such operation is necessary (whether, indeed, it always is necessary is but for another discussion I think!) so I'm inclined to think that the reasoning behind a lack of such a study would be along the lines of:
General anaesthesia is a necessary concept, essential for saving lives in many cases, therefore there isn't any point doing studies about the side-effects because it's not as if we can stop using anaesthesia.

Or I may just have my cynical hat on today

 

[EnolaGaia]

... But (notwithstanding my instinctive doubt regarding the veracity of everything...excepting birth, death and taxes) there is an emergent point, here. Has there actually ever been a proper pathological study of the after-effects of anaesthesia? ...

As far as I know, such research has been conducted for decades. One reason it's difficult to find overviews or meta-reviews is that there are so many different types of anesthesia tactics and substances. Recent such research has to focus on one or another particular type.

There's always been apprehension about general anesthesia and its possible effects, because a small fraction of the patients who 'go under' don't come out of it alive.

Here are some references on common effects, a commentary on how complicated it is for anesthesiology professionals to keep up with the possible problems, and an illustrative example of a recent article surveying one class of problems based on over a decade's clinical experience ...

The Hidden Dangers of Going Under

https://www.scientificamerican.com/article/hidden-dangers-of-going-under/

Why anesthetics cause prolonged memory loss

https://www.sciencedaily.com/releases/2014/11/141103192130.htm

Anesthesia Professionals Not Sufficiently Aware of Risks of Postoperative Cognitive Side Effects

https://www.elsevier.com/about/pres...risks-of-postoperative-cognitive-side-effects

Hypersensitivity Reactions During Anaesthesia Care: An 11-Year Experience From A Tertiary Hospital

https://www.omicsonline.org/open-ac...iary-hospital-2155-6148-1000754.php?aid=92622