Is deep anesthesia dangerous?
Summary of "Is deep anesthesia dangerous?"
Regarding the question of an adequate depth of anesthesia, over the past decade anesthesiologists have focused on the prevention of intraoperative consciousness in combination with explicit memory. Recent studies approached the topic from a different way postulating that deep anesthesia, quantified as time with a bispectral index (BIS)< 45, is associated with increased postoperative mortality and four out of the five published studies revealed such a correlation. However, the finding is limited by a suboptimal study design, e.g. none of the studies presented randomized data. Furthermore, it is ambiguous whether the correlation is causal as the administration of deep anesthesia determines higher postoperative mortality or the study results reveal an epiphenomenon. An epiphenomenon implies e.g. that patients with cancer respond to general anesthesia with deeper cortical depression. In summary, as long as there is a lack of adequately performed randomized trials, there is no reason why anesthesiologists should change the current practice.
Affiliation
Sektion Experimentelle Anaesthesiologie, Klinik für Anästhesie und Intensivmedizin, Eberhard-Karls-Universität, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland.
Journal Details
This article was published in the following journal.
Name: Der Anaesthesist
ISSN: 1432-055X
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22790476
- DOI: http://dx.doi.org/10.1007/s00101-012-2049-6
Medical and Biotech [MESH] Definitions
Delayed Emergence From Anesthesia
Abnormally slow pace of regaining CONSCIOUSNESS after general anesthesia (ANESTHESIA, GENERAL) usually given during surgical procedures. This condition is characterized by persistent somnolence.
Anesthesia, Closed-circuit
Inhalation anesthesia where the gases exhaled by the patient are rebreathed as some carbon dioxide is simultaneously removed and anesthetic gas and oxygen are added so that no anesthetic escapes into the room. Closed-circuit anesthesia is used especially with explosive anesthetics to prevent fires where electrical sparking from instruments is possible.
Anesthesia, Caudal
Epidural anesthesia administered via the sacral canal.
Sufentanil
An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.
Upper Extremity Deep Vein Thrombosis
DEEP VEIN THROMBOSIS of an upper extremity vein (e.g., AXILLARY VEIN; SUBCLAVIAN VEIN; and JUGULAR VEINS). It is associated with mechanical factors (Upper Extremity Deep Vein Thrombosis, Primary) secondary to other anatomic factors (Upper Extremity Deep Vein Thrombosis, Secondary). Symptoms may include sudden onset of pain, warmth, redness, blueness, and swelling in the arm.
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