Introduction
Prolonged anesthesia is also commonly known as a medically induced coma. This is a life-saving process, and it is carried out throughout the globe on several patients inside an intensive medical care unit. Post prolonged anesthesia, the patient undergoes several changes within themselves, physiologically. Prolonged anesthesia carries the brain of the patient to a condition of profound unconsciousness that is beyond short-term anesthesia that is used for surgical procedures. In addition to this, it is quite common for the family members of the patient to report to the healthcare facility that after being discharged, the patient is no longer quite the same mentally. It is known that intensive care unit survivors suffer numerous long-lasting cognitive impairments that include confusion along with memory loss. These have the potential to languish for weeks to months. Also, in a few cases, this may extend up to years.
Despite the research and pieces of evidence which sustains the link between prolonged anesthesia with cognition, the straightforward alterations in the patient’s neural connections have yet not been completely studied. One of the core reasons for this is that it is extremely demanding to understand a few patients' brains at a high enough resolution to monitor connections between each and every neuron.
On the other hand, the connections between neurons in the patient’s brain are generally quite stable during the administration of anesthesia. Several researchers have found that prolonged anesthesia may significantly alter the brain structure of the patient regardless of their age. Nevertheless, restorative plans for such patients, as well as extending supportive treatments that possess the brain in form during prolonged anesthesia, would drastically improve clinical outputs for those patients whose lives are saved but with the quality of life being compromised.
What Are the Effects of Prolonged Anesthesia?
An induced coma that is also referred to as a medically induced coma, MIC, prolonged anesthesia, barbiturate-induced coma, or simply drug-induced coma, is one of the types of temporary coma which puts the patient into a deep state of unconsciousness, and this is brought on by a set of controlled dose of any anesthetic medication. Still, mostly it is a barbiturate, like Pentobarbital and Thiopental. Mentioned below are a few of the uses and their expected effects post-prolonged anesthesia.
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Prolonged anesthesia protects the patient’s brain during any kind of major neurosurgery, which is considered to be the last line of treatment modality in specific cases, such as status epilepticus or other cases that have not responded to different modes of treatments, such as intracranial hypertension after a traumatic brain injury.
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Prolonged anesthesia generally results in a significant amount of systemic adverse reactions.
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The patient is most likely to completely lose their respiratory drive and may additionally require mechanical ventilation support.
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The patient may also have less gut motility, hypotension, and cerebral perfusion pressure that will require vasopressor drugs. Hypokalemia may additionally develop.
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A completely immobile patient is always at an increased risk of bed sores and infection from catheters.
It should be noted that the severity of the effects of prolonged anesthesia also varies from person to person. Some people are more susceptible to the effects of anesthesia than others.
How Does Prolonged Anesthesia Work?
When a patient undergoes a traumatic brain injury, it may result in a drastic amount of swelling of the brain. This swelling puts immense pressure on the patient’s brain, which reduces their blood flow as well as their oxygen supply and can potentially damage their brain tissues. Prolonged anesthesia allows the brain of the patient to rest and then decreases the overall activity of the brain, thus lowering the metabolic rate. This particular state aids in decreasing brain swelling and hence protects the patient’s brain from further damage. It should be known that prolonged anesthesia is not a very common medical procedure and is the last resort when options for reducing the amount of brain swelling and seizure activity have completely failed. Mentioned below are several ways of working on prolonged anesthesia.
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Prolonged anesthesia utilizes particular drugs in order to achieve a deep state of inactivity in the brain.
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This deep sleep is a reversible unconsciousness that healthcare professionals induce in order to protect the patient’s brain from further damage.
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Barbiturates ameliorate the metabolic rate of the patient’s brain tissue and cerebral blood flow.
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These reductions lead to the blood vessels in the brain narrowing, which result in a shrunken brain size which will eventually lower intracranial pressure.
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During this, the brain of the patient remains quiet for some intervals.
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This suppressed state of the brain is vital for it to rest and heal.
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In prolonged anesthesia, the time of the suppression of the brain may get longer as the level of anesthesia is elevated.
General anesthesia is another kind of medically prolonged anesthesia, but the goals are not the same. The main aim of general anesthesia is to make sure that the brain is unaware of anything and is unable to feel any sort of pain during any surgical procedure. General anesthesia and prolonged anesthesia may additionally differ in their level of unconsciousness.
Conclusion
Prolonged anesthesia is a deep state of sedation of the brain of the patients using several kinds of anesthetic drugs. The goal of prolonged anesthesia is to reach a certain level of sedation that can be called “burst suppression.” In the state of burst suppression, the brain is completely silent for a few seconds. This silence is alternated with very tiny intervals or bursts of activity in the brain, and then this is recorded by a diagnostic tool. An anesthesiologist is a specialist in prolonged anesthesia, and he or she will begin to induce the same. An anesthesiologist is a professional who specializes in pain relief as well as providing total medical safety for patients pre-surgery, during, and post-surgery. The professional may additionally look after patients even outside the surgical department in specific areas such as the ICU or the intensive care units. Once the prolonged anesthesia is administered and working, the healthcare professional and related staff will cautiously monitor the patient’s brain activity along with vital signs.
