Anesthesia is medication used to control pain, especially during surgical procedures. General anesthesia uses a combination of intravenous drugs (IV) and other chemicals that are inhaled to put you to sleep so you do not feel or remember the procedure.
A recent animal study at Massachusetts General Hospital (MGH) suggests the stimulant drug Ritalin (methylphenidate) may be helpful in allowing patients to wake more quickly after general anesthesia.
Anesthesia medications are used to reduce or eliminate pain during procedures. Some anesthesia works on a small specific part of the body. Other anesthesia drugs create an overall relaxation without forcing the patient to fall asleep.
General anesthesia works on the entire body by forcing the patient to go to sleep. It is typically used for surgeries that will take a long time, that will force the patient into an uncomfortable position, or that can affect breathing such as chest or abdominal surgery.
During general anesthesia, a trained anesthesiologist monitors breathing and heart rate and maintains the necessary level of drugs to keep the patient asleep. Researchers recognize that this “sleep” during anesthesia is different from regular sleep because the brain is not able to respond to pain signals or external stimuli such as surgical manipulations.
Research has shown that sleep under anesthesia is actually a “controlled and reversible coma.” (Science Daily)
Some patients, especially children and seniors, may have a harder time waking from general anesthesia and may experience temporary mental confusion after being anesthetized.
The longer anesthesia lasts, the more likely these and other side effects become. Currently, doctors do not have a way to cut off anesthesia. Patients must be given time for the drugs to wear off before waking up.
The MGH study suggests that the drug Ritalin could provide a safe way to wake up patients after general anesthesia. Emery Brown, MD, PhD, of the MGH Department of Anesthesia, Critical Care and Pain Medicine and senior author of the paper said, "If these findings can be replicated in humans, it could change the practice of anesthesiology -- potentially reducing post-anesthesia complications like delirium and cognitive dysfunction in pediatric and elderly patients."
Methylphenidate is commonly used to treat attention-deficit hyperactivity disorder (ADHD). The Massachusetts research showed that rats given the anesthetic isoflurane woke up significantly faster if they received methylphenidate near the end of the isoflurane treatment. The study also showed that brain rhythms in the rats showed arousal as quickly as 30 seconds after the methylphenidate was given.
The researchers plan to continue their study to see if the drug works with other general anesthetics. They believe having the ability to safely wake patients out of general anesthetic can yield significant health care savings as time spent in the operating room is reduced. They also believe their study may open new avenues of research to find a way to wake patients from comas.
Sources
Science Daily. Common Stimulant May Speed Recovery from General Anesthesia. Web. September 21, 2011.
http://www.sciencedaily.com/releases/2011/09/110921081741.htm
Mayo Clinic. General Anesthesia. Web. September 21, 2011.
http://www.mayoclinic.com/health/anesthesia/MY00100
National Institutes of Health: Medline Plus. Anesthesia. Web. September 21, 2011.
http://www.nlm.nih.gov/medlineplus/anesthesia.html
Reviewed September 22, 2011
by Michele Blacksberg RN
Edited by Jody Smith