It takes at least 3 hours for the brain to fully recover after deep anesthesia? Anesthesiologists reveal "unpredictable risks"
The cost of insurance is the highest in all specialties. Anesthesiologists often play the role of “heroes behind the scenes”
As a modern anesthesiologist, it is absolutely our duty to ensure the safety of patients during surgery when facing various emergencies and challenges. I always firmly believe that as long as we fully understand the patient’s condition, meet the needs of the operation, and draw up a thorough anesthesia plan in advance, we can provide the patient with a safe anesthesia process. Although the anesthesiologist has always been just a behind-the-scenes hero during the entire operation, it is our greatest responsibility to make the operation a success. Naturally, we can also share the joy of success through this result.
Now, looking back at the entire history of the development of anesthesia, two hundred years ago, because there was no anesthesia technology, people would rather die than wake up (alive) to undergo surgery. Although surgeries are now performed under anesthesia, which is a dream come true, does everything go as expected? The answer may not be all that satisfactory. Because anesthesia has the above unpredictable risks, anesthesiology can be said to be the most risky and insurance-expensive specialty in all clinical medicine.
Anesthesia does not make you “fall asleep”! The doctor described it more like a “recoverable coma”
Many people ask, how long does it take for the brain to return to normal after we are anesthetized? Cai Shengguo, a professor-level attending physician at Zhenxing Hospital, published “The Truth about Anesthesia” and pointed out that he quoted Emery Brown, professor of anesthesia at Harvard Medical School, as an answer: “Anesthesia is a ‘recoverable coma’”.
Because during anesthesia, the anesthesiologist must control the brain waves at the original 30% to 40% from the monitoring of the anesthesia depth monitoring instrument (whether using Entropy or BIS). The coma present at this time is short-lived and can return to a normal state of suppression, but the patient still retains blood pressure and heartbeat functions. This is completely different from true “brain death (that is, brain waves equal to 0)” where “the brainstem in the vital center is necrotic, causing breathing, blood pressure, and heartbeat to stop, and the brain waves are in a straight line.”
Simply put, anesthesia uses anesthetics to induce deep sleep in patients. During anesthesia, the patient will not be conscious and the brain waves will decrease (but not lower than 40%, let alone 0), so this does not mean death.
Deep anesthesia causes the patient’s “brain waves to weaken” and it takes at least 3 hours to fully regain consciousness.
Generally speaking, “dreaming” when people sleep means “poor sleep quality.” Because dreaming usually occurs in the “rapid eye movement (REM) period of sleep” when there is no deep sleep; however, patients who fall asleep under anesthesia are induced by drugs to enter a “deep anesthesia” state, which is a state of unconsciousness, no feeling, In sleep without pain and reflex reactions, there is no so-called “sleep cycle” at all, and naturally there will be no “rapid eye movement sleep” and dreaming. Not to mention that anesthesia is a “recoverable coma”. Since the patient is in a “coma” state, he will naturally not “dream”!
Previously, George Mashous, professor of anesthesia at the University of Michigan, used electroencephalograms to conduct research on two groups of thirty patients each (one group underwent deep general anesthesia, and the other group slept naturally). It was found that recovery from anesthesia is different from “waking up naturally”, but “recovering only part of it at a time, not all at once”. Among them, the earliest part of the brain to return to normal is the “Prefrontal Cortex”, which is mainly responsible for problem solution memory (Problem Solution Memory) and motor functions. As for the responses of other brain areas, including reaction time control and attention recovery, it takes longer (about 3 hours) to fully recover.
There are “unpredictable” risks in surgery, and “specialization” in anesthesia ensures patient safety.
For the patient, from the moment he closes his eyes under anesthesia until he wakes up from anesthesia, the whole process seems to only take “one second”. Because during this anesthesia process, he had almost lost all consciousness and feeling, as if he was dead. Who knows, the anesthesia time may last several hours or even a whole day as the surgery progresses. During this long period of time, there are actually many potential “unpredictable” risks (such as malignant hyperthermia, difficult intubation, drug allergies, thyroid storm, etc.). At this time, the anesthesiologist must pay attention to the patient’s vital signs at all times and make no mistakes to ensure the patient’s anesthesia safety during the operation.
Especially in recent years, it has been affected by population aging. According to statistics in 2018, Taiwan’s elderly population has increased by 14.2% over the past decade, but health insurance costs have increased by 38.2%. , heart valve degeneration and other diseases) account for an increasing proportion. As the elderly undergo more surgeries, the risks of anesthesia naturally increase. Coupled with the emergence of complex surgeries in various disciplines, anesthesia has also begun to become “specialized”.
Up to now, specialties such as cardiology, neurology, obstetrics and pediatric anesthesia have been developed, and the development is becoming more and more diversified. In Japan, people who have obtained a medical license can claim to be doctors in various disciplines such as internal medicine, surgery, dermatology, etc., but only anesthesiologists must pass a special qualification examination by the Ministry of Health, Labor and Welfare.
It can be seen from this that anesthesiology is a specialized profession that requires a high degree of special skills and concepts.
