The anaesthesia dilemma

Anaesthesia can have a significant impact on brain development

Understanding the basis and treatment of disease.

Moderators: kiore, Blip, The_Metatron

Re: The anaesthesia dilemma

#21  Postby Sendraks » Jul 01, 2015 2:05 pm

Spearthrower wrote:

It's not all about you, Dave. I was just riffing off Sendraks' point - that's all.


Quite! :thumbup:
And my point was that people usually get put under anaesthetic because life threatening complications need to be dealt with or that some sort of intervention is necessary because while it might not be life saving, it may well improve quality of life or prevent further complications arising in the future.

With anaesthesia you're already making a decision to do something which can be fatal in and of itself.
"One of the great tragedies of mankind is that morality has been hijacked by religion." - Arthur C Clarke

"'Science doesn't know everything' - Well science knows it doesn't know everything, otherwise it'd stop" - Dara O'Brian
User avatar
Sendraks
 
Name: D-Money Jr
Posts: 15260
Age: 107
Male

Country: England
Print view this post

Re: The anaesthesia dilemma

#22  Postby Sendraks » Jul 01, 2015 2:06 pm

Nicko wrote:Just as an alternative hypothesis, might there be a causal relationship between suffering a condition in early childhood serious enough to warrant a procedure that in turn warranted anaethesisa and cognitive impairment?


That's pretty much what I've been saying.
"One of the great tragedies of mankind is that morality has been hijacked by religion." - Arthur C Clarke

"'Science doesn't know everything' - Well science knows it doesn't know everything, otherwise it'd stop" - Dara O'Brian
User avatar
Sendraks
 
Name: D-Money Jr
Posts: 15260
Age: 107
Male

Country: England
Print view this post

Re: The anaesthesia dilemma

#23  Postby Spearthrower » Jul 01, 2015 2:06 pm

Sendraks wrote:As things stand, we appear to be about two years away from hard data on whether anaesthesia is likely to cause cognitive issues in later life for younger people. Now clearly this is something I'm all for, because medics can't make informed decisions based on speculation and uncertainty. Furthermore, hard evidence makes for a compelling case to look at new approaches to anaesthesia or ever more novel approaches to avoiding its use.

Reliable evidence would also be a great boon for patients in making decisions about whether to undergo a procedure via anaesthetic or not, if a safe alternative is available. As a rule, medical teams prefer not to anaesthetise patients if another option is available (because anaesthesia is risky business fullstop), but in some cases the patient may wish to exercise the choice of being put under and the medical team may decide that not exposing the patient to stress by being conscious, is the way to go.

Sadly the "at-risk" group here appears to be children and I can understand a terrified child wanting not be awake to experience surgery, whilst the patients would be rightly pushing for an alternative if evidence showed this would present real problems for the child in the future.



There's clearly only one sensible answer here: any child having surgery under the age of 6 should be given a quart of whisky!

Actually, I just wanted to say I agree with everything you've written above, but perhaps it's our friendship clouding my judgment because, you know, I'm a bit dappy like that.
I'm not an atheist; I just don't believe in gods :- that which I don't belong to isn't a group!
Religion: Mass Stockholm Syndrome

Learn Stuff. Stuff good. https://www.coursera.org/
User avatar
Spearthrower
 
Posts: 33854
Age: 47
Male

Country: Thailand
Print view this post

Re: The anaesthesia dilemma

#24  Postby Spearthrower » Jul 01, 2015 2:07 pm

Nicko wrote:Just as an alternative hypothesis, might there be a causal relationship between suffering a condition in early childhood serious enough to warrant a procedure that in turn warranted anaethesisa and cognitive impairment?


Yup, and this is why knee-jerkism is not a rational approach! :cheers:
I'm not an atheist; I just don't believe in gods :- that which I don't belong to isn't a group!
Religion: Mass Stockholm Syndrome

Learn Stuff. Stuff good. https://www.coursera.org/
User avatar
Spearthrower
 
Posts: 33854
Age: 47
Male

Country: Thailand
Print view this post

Re: The anaesthesia dilemma

#25  Postby Spearthrower » Jul 01, 2015 2:09 pm

DavidMcC wrote:Well, it could be that I've become over-cynical because of all the innuendos that get thrown at me at any opportunity. People seem to have learned the art of the deniable innuendo.


Oh sorry, my mistake. It is *all* about you.


DavidMcC wrote:[/Spearthrower's derail]


*chokes*

MY derail?

:lol:
I'm not an atheist; I just don't believe in gods :- that which I don't belong to isn't a group!
Religion: Mass Stockholm Syndrome

Learn Stuff. Stuff good. https://www.coursera.org/
User avatar
Spearthrower
 
Posts: 33854
Age: 47
Male

Country: Thailand
Print view this post

Re: The anaesthesia dilemma

#26  Postby DavidMcC » Jul 01, 2015 2:10 pm

Nicko wrote:Just as an alternative hypothesis, might there be a causal relationship between suffering a condition in early childhood serious enough to warrant a procedure that in turn warranted anaethesisa and cognitive impairment?

Most childhood anaesthesias are probably either for dental operations, or as a result of accidents. Neither of these are likely in themselves to cause cognitive impairment in later life, IMO.
EDIT: OK, maybe a head injury could cause later cognitive impairment, but not, say, a leg injury.
Last edited by DavidMcC on Jul 01, 2015 2:11 pm, edited 1 time in total.
May The Voice be with you!
DavidMcC
THREAD STARTER
 
Name: David McCulloch
Posts: 14913
Age: 70
Male

Country: United Kigdom
United Kingdom (uk)
Print view this post

Re: The anaesthesia dilemma

#27  Postby Nicko » Jul 01, 2015 2:11 pm

DavidMcC wrote:FURTHER EDIT: IF more conclusive evidence of neurological damage from anaesthetics is obtained, doctors and surgeons may well feel obliged to make children suffer much pain in operations, to ensure that they do not suffer in the future.


Not so much. Perhaps.

Extremely painful experiences are linked - much more robustly - with cognitive alteration and psychological disorders.

It doesn't make much sense to avoid the potential risk of a later cognitive impairment by exposing a patient to a known high level of risk for mental health problems.
"Democracy is asset insurance for the rich. Stop skimping on the payments."

-- Mark Blyth
User avatar
Nicko
 
Name: Nick Williams
Posts: 8643
Age: 47
Male

Country: Australia
Australia (au)
Print view this post

Re: The anaesthesia dilemma

#28  Postby Spearthrower » Jul 01, 2015 2:12 pm

DavidMcC wrote:
Nicko wrote:Just as an alternative hypothesis, might there be a causal relationship between suffering a condition in early childhood serious enough to warrant a procedure that in turn warranted anaethesisa and cognitive impairment?


Most childhood anaesthesias are probably either for dental operations, or as a result of accidents. Neither of these are likely in themselves to cause cognitive impairment in later life, IMO.



Surely that would depend on the nature of the accident.

And of course, the point still remains that dying now represents a rather severe cognitive impairment in the future.
I'm not an atheist; I just don't believe in gods :- that which I don't belong to isn't a group!
Religion: Mass Stockholm Syndrome

Learn Stuff. Stuff good. https://www.coursera.org/
User avatar
Spearthrower
 
Posts: 33854
Age: 47
Male

Country: Thailand
Print view this post

Re: The anaesthesia dilemma

#29  Postby DavidMcC » Jul 01, 2015 2:15 pm

Nicko wrote:
DavidMcC wrote:FURTHER EDIT: IF more conclusive evidence of neurological damage from anaesthetics is obtained, doctors and surgeons may well feel obliged to make children suffer much pain in operations, to ensure that they do not suffer in the future.


Not so much. Perhaps.

Extremely painful experiences are linked - much more robustly - with cognitive alteration and psychological disorders.

It doesn't make much sense to avoid the potential risk of a later cognitive impairment by exposing a patient to a known high level of risk for mental health problems.

If that is true, then there is no good solution. :(
May The Voice be with you!
DavidMcC
THREAD STARTER
 
Name: David McCulloch
Posts: 14913
Age: 70
Male

Country: United Kigdom
United Kingdom (uk)
Print view this post

Re: The anaesthesia dilemma

#30  Postby Thomas Eshuis » Jul 01, 2015 2:20 pm

:coffee:
"Respect for personal beliefs = "I am going to tell you all what I think of YOU, but don't dare retort and tell what you think of ME because...it's my personal belief". Hmm. A bully's charter and no mistake."
User avatar
Thomas Eshuis
 
Name: Thomas Eshuis
Posts: 31091
Age: 34
Male

Country: Netherlands
European Union (eur)
Print view this post

Re: The anaesthesia dilemma

#31  Postby Thommo » Jul 01, 2015 2:20 pm

Spearthrower wrote:
Thommo wrote:I like the way this thread is going! :thumbup:


Stop suggesting things about my male pattern balding! :(


Let me know when your birthday is and I'll gift you a nice rug. :razz:
User avatar
Thommo
 
Posts: 27476

Print view this post

Re: The anaesthesia dilemma

#32  Postby Sendraks » Jul 01, 2015 2:25 pm

DavidMcC wrote:
If that is true, then there is no good solution. :(


Not so, the "good solution" should be whatever the medical team deems to be best for the patient. That's a rather idealised view of medical practise, but at its core it is what should be.

Do the risks of anaesthesia (including the long term complications) outweigh the benefits? If the answer is yes, then ideally whatever the complications are down the line, they are less worse than whatever problem is going to be corrected by surgery under anaesthesia.

And this risk vs benefits analysis isn't just limited to anaesthesia. Most medical treatments that a doctor will prescribe you, have a list of potential side effects as long as your arm, although realistically the best known/most likely side effects are the ones a good doctor will have in mind when making a prescription.

In my own experience - prescribing anti-depressants was decision between either a) a patient who was a suicidal or b) who would not be suicidal, but might experience fatigue, a repression emotions and some other side effects I'm not going into.

Patient might kill himself vs patient feels fairly shitty.

Clearly there is no good scenario, but the less worse scenario is the patient not killing himself one.
"One of the great tragedies of mankind is that morality has been hijacked by religion." - Arthur C Clarke

"'Science doesn't know everything' - Well science knows it doesn't know everything, otherwise it'd stop" - Dara O'Brian
User avatar
Sendraks
 
Name: D-Money Jr
Posts: 15260
Age: 107
Male

Country: England
Print view this post

Re: The anaesthesia dilemma

#33  Postby laklak » Jul 01, 2015 3:07 pm

It's medical experimentation for the lot of you.
A man who carries a cat by the tail learns something he can learn in no other way. - Mark Twain
The sky is falling! The sky is falling! - Chicken Little
I never go without my dinner. No one ever does, except vegetarians and people like that - Oscar Wilde
User avatar
laklak
RS Donator
 
Name: Florida Man
Posts: 20878
Age: 70
Male

Country: The Great Satan
Swaziland (sz)
Print view this post

Previous

Return to Medicine

Who is online

Users viewing this topic: No registered users and 0 guests