10 Recently Published Studies on Anesthesia

Here are 10 recently published studies on anesthesia, taken from various journals and news sources.

1. Local anesthesia could speed up orthopedic surgery 50 percent. A group of anesthesiologists at St. Paul's Hospital in Vancouver, Canada, believe a new surgical method involving local anesthesia could speed up orthopedic operations by more than 50 percent. The surgical method involves using two operating rooms staffed by one surgeon and one anesthesiologist, and the patient is given local rather than general anesthesia.

2. Post-operative nausea and vomiting may have genetic link. A study from the July 2011 issue of Anesthesiology analyzed whether patients who experience post-operative nausea and vomiting have a genetic predisposition to the side effect. Researchers from Penn State College of Medicine pooled DNA samples from 122 patients with severe PONV to determine whether PONV is inherited. The findings identified 41 genetic targets, called single nucleotide polymorphisms, in these patients that might have caused a predisposition to PONV.

3. Video education can improve intubation skills in medical students. Education using a video system mounted into a traditional Macintosh blade improved intubation skills in medical students, according to a study published in the June 2011 issue of Anesthesia & Analgesia. The study found that students trained with a videolaryngoscope had an intubation success rate on a manikin 19 percent higher and intubated 11 seconds faster compared to those trained using a conventional laryngoscope.

4. Propofol anesthesia may increase recall of traumatic events. In an editorial for Anesthesiology, J. Lance Linchtor Mr. Lichtor cited a study published this month in the journal that reasons propofol might affect memory consolidation of emotionally arousing experiences through activation of the endocannabinoid system. The study showed that propofol was linked to 48-hour memory enhancement, and higher doses of propofol were linked to longer retention of memory. Mr. Lichtor said if the study translates directly to humans, propofol may produce enhanced recall of a traumatic event if administered shortly afterward.

5. Risk of neurodevelopmental impairment from anesthesia still exists.
There is still a significant risk of neurodevelopmental impairment in neonates that undergo cardiac surgery, according to several studies reported in Anesthesiology News. According to Dean Andropoulos, MD, and his colleagues at Texas Children's Hospital in Houston, optimizing cerebral oxygenation in neonates undergoing cardiac surgery could lower the incidence and severity of new brain injury postoperatively, as determined by MRI.

6. Catheter delivery requires lower dose of anesthesia than single spinal injection. A study presented at the 2011 annual meeting of the Society of Obstetric Anesthesia and Perinatology found that women undergoing C-sections may require a smaller dose of anesthesia when administered through an intrathecal catheter rather than through a spinal injection. The patients who received medication through intrathecal catheters needed up to 50 percent less than published doses of the same medication delivered through one spinal injection.

7. Ketamine can act as a fast-acting antidepressant. The anesthetic ketamine may produce a fast-acting antidepressant response in patients with treatment-resistant depression, according to a study published in the journal Nature. According to researchers from the University of Texas Southwestern Medical Center, the drug can serve as a fast-acting antidepressant even at low doses. The study found that ketamine produces a sharp increase that immediately relieves depression

8. Brain loses consciousness one area at a time.
A new technique allows researchers to view real-time, 3-D images of a patient's brain as the patient undergoes anesthesia from propofol, according to a report by TIME. The findings from the new technique have shown that consciousness fades "as though a dimmer is being dialed down" rather than switches off. The research also shows that consciousness inhabits the connections between multiple areas of the brain.

9. Patient expectations alter the effect of analgesia. Patients' expectations about analgesia and hyperalgesia can alter the efficacy of an opioid and lead to neurologic changes in the brain regions associated with evaluating pain intensity, according to a study reported in Pain Medicine News. The study, which used a small sample of health volunteers, showed that patients' beliefs about their symptoms can shape their experience of pain and alter their neural activity.

10. Few anesthesiologists monitor oxygen flow during high-risk surgery. Only one-third of anesthesiologists measure oxygen flow throughout the patient's body during high-risk surgery, even though heart function can significantly affect recovery, according to a survey by researchers in Amsterdam. The researchers surveyed 463 European and American anesthesiologists and found that while 95 percent knew it was critically important for oxygen to reach all parts of a patient's body during high-risk surgery, only 35 actually monitored cardiac output.

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