Any relation to integrated information theory (IIT, Koch et al)?
In kids, EEG monitoring of consciousness safely reduces anesthetic use
31–40 of 93 posts
Re: In kids, EEG monitoring of consciousness safely reduces anesthetic use
#32Earlier quoted context omitted.
> very rough on you How so?
Rough like the roughest hangover you can have. I had a general anesthesia at 21 for dental surgery. The come back was a nightmare: nausea, shaking, cold and hot alternating, terrible headache, cramps, exhausted and mentally depressed during ~2 days. I couldn't eat, I couldn't drink (but brute force myself to do it), I couldn't think or concentrate on anything but the pain. The only close experience I can remember is…
Probably Ketamine.
Re: In kids, EEG monitoring of consciousness safely reduces anesthetic use
#33Earlier quoted context omitted.
https://www.sciencedirect.com/science/article/pii/S152659001... > textbooks at the time taught that [open heart] surgery [...] ‘‘could be safely accomplished with only oxygen and a paralytic’’ 69(p.580) when performed on infants. Textbooks isn't "some doctors errorneously believed", it is what most doctors believed, taught and practiced. > infant surgery routinely conducted with no or minimal anesthesia well into the…
I think there is a definitional problem with "kids" vs "infants" vs "newborns" which are all difficult to define, the type of anaesthesia that was administered and we are also talking about 40 years ago. Our understanding of anaesthetics and heart surgery in newborns was much different than today. America definitely has a checkered and sordid past here and in psychiatry. But we also have a duty to be definitionally e…
I admit that "kids" is a bit imprecise and can lead to misunderstandings. But that is just not important to this discussion.
And the exact definition of the anesthesia given to most infants before 1987: A paralytic. Nothing else.
If you feel adventurous, have your family doctor give you a paralytic and then push a sterile needle under your fingernail. Then tell me the exact definition of sufficient anesthesia in that case ;)
Re: In kids, EEG monitoring of consciousness safely reduces anesthetic use
#34Earlier quoted context omitted.
My wife is a doctor and provided me (layperson) the following context. Apparently EEG is now used in most adult surgeries and has been increasing over time. It is used as a marker of how 'asleep' you are to guide how much medication you get. However, this is relatively recent and the use of EEG in kids (where the brainwaves are different) was not studied/used as much. It seems like this study pushes towards a future…
I’m good here. Thanks.
What about people who routinely use drugs in heavier concentrations or who have higher tolerance from genetics? How is that detected?
Re: In kids, EEG monitoring of consciousness safely reduces anesthetic use
#35Why is this about kids? Do we already measure EEG for adults? Or not? If we do, why has it taken so long to do with kids? If not, is this a first step? Why start with kids rather than adults? This article provides shockingly little context.
Doctors not too long ago would tell you that infants don't experience pain. There are a lot of not backed by science beliefs in the medical field that won't die until the doctors that believe them do. https://pubmed.ncbi.nlm.nih.gov/23548489/
An example is that thin people cannot possibly have sleep apnea, it only affects overweight people. Overly-confident Dunning-Kruger doctors adamantly declared this as "truth" to me enough times that it stalled me getting properly treated at least a decade.
Re: In kids, EEG monitoring of consciousness safely reduces anesthetic use
#36Earlier quoted context omitted.
https://www.sciencedirect.com/science/article/pii/S152659001... > textbooks at the time taught that [open heart] surgery [...] ‘‘could be safely accomplished with only oxygen and a paralytic’’ 69(p.580) when performed on infants. Textbooks isn't "some doctors errorneously believed", it is what most doctors believed, taught and practiced. > infant surgery routinely conducted with no or minimal anesthesia well into the…
I don’t know where the truth lies, but even if everything you wrote is true (and it does sound reasonable to me), not giving anesthesia might still be a safer choice considering the side effects. Not saying it is, only saying that we need to take a look at the side effects and risks, and all other (at a time) available information before we call them barbarians.
At some point in adult medicine, it was recognized that using an analgesic during surgery, in addition to the then normal combination of paralytic and hypnotic, significantly increased survival rates. This fact was independent of the patients capacity to remember the pain and wasn't any kind of psychological response like PTSD. It was the basal reaction to injury and pain by stress that killed those patients.
The exact same reaction kills non-adults. The proof took longer, but it is there now. That doctors even needed proof instead of, without further experimental knowledge, assuming the null hypothesis of children being small adults in this case already is proof of a kind of chauvinistic barbarism. Infants were some kind of lesser human to them, thus couldn't react in the same way as adults.
Remember, the norm was _no_ analgesia, _no_ pain relief. For the majority of infants. Its not that they decided on a case by case basis on the right balance of analgesia vs. risk. They decided as a matter of course that analgesia was superfluous for infants.
Re: In kids, EEG monitoring of consciousness safely reduces anesthetic use
#37"Kids don't need anesthetics. If they are young enough, they won't remember the pain, so you can just operate without anesthetics. They are also easier to restrain than adults." This was state of the art in medicine for quite some time. I fear the general trend of "medication bad" will get us back to those dark times. Btw, those dark times ended only as recently as 1987! https://www.newsweek.com/when-doctors-start-us…
Compare that with the whole “twilight sleep” way of delivering babies and you can see a whole misogynistic thread of not respecting natural systems and of trying to minimize or eliminate the behavioral symptoms of pain while doing little to actually ease the patient.
Re: In kids, EEG monitoring of consciousness safely reduces anesthetic use
#38Why is this about kids? Do we already measure EEG for adults? Or not? If we do, why has it taken so long to do with kids? If not, is this a first step? Why start with kids rather than adults? This article provides shockingly little context.
Doctors not too long ago would tell you that infants don't experience pain. There are a lot of not backed by science beliefs in the medical field that won't die until the doctors that believe them do. https://pubmed.ncbi.nlm.nih.gov/23548489/
'A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows up that is familiar with it.'
— Max Planck
Re: In kids, EEG monitoring of consciousness safely reduces anesthetic use
#39If the reporting is accurate, which is really not a given with MIT, this is great news. For all its upsides, general anesthesia is still dangerous and very rough on you, and all these effects are always amplified for young patients.
> very rough on you How so?
I had anesthesia for a surgery at age 15 and I was depressed for a year afterward.
I’m sure everyone’s experience is different, but it made me feel groggy in a way that was difficult to bounce back from.
Re: In kids, EEG monitoring of consciousness safely reduces anesthetic use
#40Earlier quoted context omitted.
I’m good here. Thanks.
MAC doesn't indicate the depth of the anesthesia. It indicates the depth of the paralysis. Which is exactly the problem EEG monitoring is supposed to prevent: In some cases patients can have an insufficient response to analgesia (so they will feel pain) and hypnotics (so they are awake, aware and forming memories) but will respond to paralytics (so they are unable to move and communicate their predicament). So with t…
Good day to you.