Word: anesthesia
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Dates: during 2000-2009
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...much of recorded history, many doctors saw the human heart as the inscrutable, throbbing seat of the soul, an agent too delicate to meddle with. After a few incremental advances, that changed on a wide scale with World War II, when massive carnage forced military doctors to experiment with anesthesia and the other elements of modern surgery. Dr. Dwight Harken, a young Army surgeon, managed to remove shrapnel and bullets from some 130 soldiers' chests without killing one. Buoyed by such successes, in the postwar years surgeons made rapid advances in heart treatments. But they struggled to perform operations that...
...Fittingly, the initial discovery of the potentially neurotoxic effect of anesthesia occurred by accident. In the 1990s, scientists discovered that the brain cells of patients in the midst of a stroke were flooded with calcium. Doctors wishing to treat these patients hypothesized that blocking the receptor that enables calcium to enter cells could protect stroke patients from severe brain damage. But in the course of researching this possibility, they found that switching off the receptor in a healthy brain cell led to the death of that cell - an unexpected and troubling result, given that many common anesthetics block the same...
...their clinical significance. No population study has ever conclusively linked anesthetic drugs to Alzheimer's or dementia. (Although doctors have long noted that about 10% of patients who receive anesthetics for major surgery experience a temporary period of "post-operative cognitive decline" after coming out of anesthesia, the condition is not limited to elderly patients, and it could be the result of inflammation or other stress responses to major surgery, rather than the anesthetic.) The only research to associate surgical anesthesia in infancy to cognitive impairment later in life was Wilder's study earlier this year, but the literature...
...Some researchers, including Lisa Wise-Faberowski, an assistant professor of anesthesiology and pediatric cardiology at the University of Colorado, Denver, think the effect in humans won't be easy to show. At the ASA conference, Wise-Faberowski devoted her presentation to chiding researchers for worrying prematurely about "anesthesia-induced neurotoxicity," pointing out that it has been seen only in "cell cultures and lab animals." If anesthetics have always been neurotoxic, one slide in her presentation asked, "Why is it only an issue now?" She and others point out that non-human testing of anesthetic safety has an unreliable history...
...Every doctor interviewed for this article urged patients not to avoid necessary surgery or forgo required anesthesia. To understand the consequences of going without anesthesia, Wilder points to certain surgical trends in the 1960s. Believing that babies were still too underdeveloped to feel pain, many doctors at the time advocated only light anesthesia or none at all for infants undergoing surgery. "The morbidity and indeed mortality levels were much higher [in these babies]. The stress response to the pain of the surgery proved dangerous," Wilder explains. It is also important to remember how primitive surgical painkilling mechanisms were before...