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  • Knocked out, going under, sedatedput to sleep...there are plenty of  

  • creative terms used to describe the  experience of being under anesthesia,  

  • but how does anesthesia actually put you to  sleep? The crazy thing is, we don't actually  

  • know for surebut as you'll see in this  video, sometimes it can go horribly wrong….

  • Anesthesia is one of the most commonly  performed medical procedures out  

  • there - more than 60,000 people undergo  anesthesia every single day in the U.S.  

  • alone. Despite its prevalence  we still don't fully understand  

  • exactly how anesthesia works in the human body  to put us to sleep - we just know that it works.

  • The word anesthesia means 'loss of sensation',  

  • and millions of Americans undergo anesthesia  every year to prevent them from feeling pain  

  • and to keep them still and unresponsive so that  doctors can safely perform life saving operations  

  • that would be incredibly difficult - not to  mention painful - to do to a conscious patient.

  • We may not fully understand how anesthesia  works, but that doesn't mean it isn't a real life  

  • medical miracle. Before the late 1800s, the  onlydrugswe had to help patients through  

  • painful procedures were things like alcoholopium and hemlock - hardly fool-proof methods.  

  • For centuries, medical procedures like tooth  extractions and fracture repairs were performed  

  • with very little - if any - pain relief for the  patient. But, beginning in the 1840s, scientists  

  • discovered that some gases, like sulphuric ether  and chloroform, had sedative effects. Anesthesia  

  • was born, and medical treatment became wildly less  painful and traumatic than ever before in history.  

  • Modern anesthesia cocktails are much safer  and more reliable than these first gases were,  

  • but we're still at a loss to explain  exactly how they work to put us to sleep.

  • There are 4 categories of anesthesia - localregional, sedation and general anesthesia. Local  

  • anesthesia involves injecting a small amount of  the drug into a specific area. This is the type of  

  • anesthesia you'd get at the doctor's office before  a filling or at the hospital before they stitch  

  • you up. It's also used after major surgeries to  help with pain as other, strong anesthesia begins  

  • to wear off. Local anesthetic numbs only the  targeted area, and wears off relatively quickly.

  • Similar to local anesthesia, regional  anesthesia targets a specific area of the body,  

  • though it is stronger than local anesthesia and  can block sensation to an entire section of the  

  • body. Epidural injections to the spine that  are used to numb the lower body during labor,  

  • and femoral nerve blocks that are injected  into the femoral artery in the upper thigh  

  • to freeze the entire leg for orthopedic surgery  are just a few examples of regional anesthesia.

  • Both local and regional anesthesia leave the  patient fully conscious - they don't “put you  

  • under”. We need stronger stuff for that. Regional  anesthesia is often combined with sedation. These  

  • twilight sedationdrugs make the patient  more relaxed and unfocused. They don't force  

  • the patient into unconsciousness, but many people  do fall asleep under sedation due to the drowsy,  

  • sleepy feeling it induces. Sedation  doesn't affect breathing or reflexes,  

  • making it less risky than full general  anesthesia, and it also wears off more quickly.

  • When you picture a patient lying unconscious  on the operating table waiting to be cut open,  

  • what you're picturing is someone under general  anesthesia. General anesthetic affects the entire  

  • body and works in 4 ways. It immobilizes the  body to stop it from moving during the procedure  

  • and acts as an analgesic to prevent  the patient from feeling any pain.  

  • It also works on the brain by sedating  the patient in an unconscious state,  

  • and even induces amnesia to ensure the  patient will have no memory of the experience.

  • In reality, “put to sleepis not the best way  to describe what it's like to be under general  

  • anesthesia - it's actually more like being in  a drug-induced coma. "It's a reversible coma,  

  • but it's nevertheless a coma," says Emery Brown,  a professor of anesthesiology at Harvard Medical  

  • School. When under general anesthesia, an  electroencephalogram, or EEG test, shows that  

  • brain activity decreases down to levels very close  to what we expect to see in cases of brain-stem  

  • death. It's no wonder patients find the euphemism  “put to sleepto be a less scary description!

  • So, what does it actually feel like to  getput underwith general anesthesia?  

  • Donna Penner's story provides a glimpse into  the mysterious experience of being under  

  • anesthesia - as well as a potent warning about how  sometimes, things can go terribly, terribly wrong.

  • Donna, a 45 year old mother from ManitobaCanada, had been experiencing some worrying  

  • and unexplainable symptoms, so her doctor  recommended an exploratory abdominal surgery  

  • to see if they could find the  cause of her mysterious issues.

  • On the day of her surgery, Donna was  understandably nervous to beput under”, but  

  • she was eager to get to the bottom of her unusual  symptoms. She met with her anesthesiologist, who  

  • talked her through the process and assured her he  would be by her side the entire time. Since Donna  

  • didn't have any of the risk factors that could  lead to a complication - she was a nonsmoker,  

  • not overweight, with no underlying medical  conditions - he assured her that things should  

  • go smoothly, and that she wouldn't remember  a thing when she woke up after the operation.  

  • The only downside was that Donna had to fast  for 6 hours before her surgery to ensure that  

  • her stomach was empty and reduce the risk  of vomiting or choking while she was under.

  • Finally, Donna was prepped for surgery  and wheeled into the operating room,  

  • where she was greeted by her anesthesiologistAs the surgeon was busy getting prepared for the  

  • operation, the anesthesiologist placed a mask  over Donna's mouth and administered a cocktail  

  • of hypnotic agents, opioids, muscle relaxantssedatives and cardiovascular drugs to Donna.  

  • He held her hand and comforted her as she drifted  into unconsciousness before inserting a breathing  

  • tube down her throat to help her breath and  prevent choking, since the anesthesia relaxes  

  • breathing and coughing reflexes. He also placed  3 sticky patches on Donna's chest connected to an  

  • electrocardiogram, or ECG machine, to monitor her  heart rate, secured a blood pressure cuff on her  

  • arm, and clipped a pulse oximeter to her finger  to monitor the oxygen level in Donna's blood.

  • True to his word, Donna's anesthesiologist  would remain by her side throughout the  

  • entire operation, carefully monitoring  her stats and ensuring that she was  

  • getting a continual dose of anesthesia  drugs. But, despite his watchful eye,  

  • there was one thing her anesthesiologist  couldn't see - Donna was actually awake.

  • Horrifically, Donna had woken up just before the  surgeon was about to make his very first cut.  

  • She was fully conscious but immobilizedunable to speak or to signal to the room  

  • full of doctors and nurses that she was awake  and aware. She remained frozen in place on the  

  • table as the surgeon sliced open her abdomen and  explored her insides, poking and prodding at her  

  • organs for hours. All the while, Donna could  feel everything - every excruciating slice,  

  • every horrible movement. She was in terribleagonizing pain, and she was helpless to do  

  • anything about it - she couldn't move or screamand she was sure she was going to die. “I thought,  

  • 'This is it,” says Donna. “This is how I'm going  to die, right here on the table, and my family  

  • will never know what my last few hours were like  because no one's even noticing what's going on.'”

  • Miraculously, Donna survived her ordealthough her recovery was long and painful.  

  • Even once her body had healed, the experience  left her with lasting psychological scars.  

  • She developed severe Post Traumatic Stress  Disorder, or PTSD, as a result of her horrific  

  • experience on the operating table, and suffered  from anxiety and panic attacks for years.  

  • Donna remembers having a full blown panic attack  one day when out shopping. She had stayed in the  

  • car while her daughter quickly ran into the  store, but when Donna realized that the car  

  • doors were locked and she was trapped insideit triggered an intense flashback to the day,  

  • more than a decade prior, when she had been  trapped and helpless on the operating table.  

  • To this day, Donna cannot stand to wear any  clothing that is tight around her neck, because  

  • it makes her feel like she can't breath and takes  her back to her ordeal in the operating room.

  • No one knows exactly why Donna woke up during  her surgery, but it's estimated that as many  

  • as 1 in every 1,000 patients are believed to wake  up at some point while under general anesthesia.  

  • More recent studies show that this number  may be even higher. It's yet another of the  

  • many mysteries surrounding anesthesia and  exactly how and why it works - or doesn't.

  • Thankfully, Donna's terrifying experience  is rare. For most patients who getput  

  • underwith general anesthesia, the process  goes smoothly and their surgeons are able  

  • to do their work without the patient having any  awareness of the trauma happening to their body.  

  • When they wake up, usually about an hour after the  anesthesiologist stops administering the drugs,  

  • they have no memory of the experience. It  can actually feel quite surreal - the last  

  • thing they remember is the mask over their  face as they drift off into unconsciousness,  

  • and when they come to in the recovery room  it can feel like no time at all has passed.

  • It's normal to feel a littleout of itas  the anesthesia wears off - patients can feel  

  • emotional or loopy, may lack inhibitions  or behave in an exaggerated manner,  

  • and can have slurred speech for a few hours  after anesthesia. If everything went smoothly,  

  • it can actually be quite funny - at least for  their loved ones and nurses. The process of coming  

  • out of anesthesia is medically quite similar to  the experience of a patient who has woken up from  

  • a vegetative state, which makes sense when we  think about the fact that being under anesthesia  

  • is essentially being in a medically-induced comaThe stages of recovery are pretty much the same,  

  • though they happen quite a bit  faster when coming out of anesthesia.

  • Side effects are common after undergoing  anesthesia. Most of them are not serious and  

  • will go away on their own within a few hours to  a few days. It's normal to experience vomiting,  

  • dizziness, and headaches after waking up from  anesthesia, and a sore throat or even a chest  

  • infection can be expected as a result of the  breathing tube that was used during the procedure.  

  • Confusion and memory loss are also quite  common, and usually resolve quickly. That said,  

  • in very rare circumstances, more  serious side effects can occur,  

  • including nerve damage, a severe allergic  reaction to the anesthesia drugs,  

  • awareness during surgery - like what Donna  experienced - and even, sometimes, death.

  • Even though we know very little about how  anesthesia actually works, it's an essential - if  

  • imperfect - tool in modern medicine, and it's not  likely going anywhere anytime soon. Thankfully,  

  • scientists are working hard to improve  our understanding of how anesthesia works,  

  • and to develop more advanced techniques to make  anesthesia more effective and more targeted.

  • Anthony Hudetz works in the Department of  Anesthesiology at the Medical College of  

  • Wisconsin, Milwaukee, and he is just one of the  many researchers working to better understand  

  • and improve anesthesia. Hudetz imagines a world  where anesthesia is less of a “hammer to the head,  

  • knock-outexperience, and more  of a delicate and specific tool.  

  • "We can also develop better anesthetic drugs  that would target consciousness itself,  

  • because today's anesthetics affect every cell in  the body," Hudetz says. "They suppress the heart  

  • and they affect all the major organs; they affect  the circulation; they suppress blood pressure,  

  • heart rate. And this is tolerable but we mostly  operate on injured people and sick people,  

  • and in that case these side effects of anesthetics  are undesirable and should be minimized."

  • Anesthesia researchers are learning a lot by  collaborating with coma and sleep researchers  

  • to share knowledge and develop more delicate  tools that can help across multiple fields.  

  • Hopefully, this will mean fewer harrowing  stories like Donna's, and one day soon,  

  • we might actually know how  anesthesia puts you to sleep.

  • If you thought this video was shocking, you'll  want to be sure and check out our other videos,  

  • like this one calledThe Most Painful  Things A Human Can Experience”. Or,  

  • maybe this other video is for you.

Knocked out, going under, sedatedput to sleep...there are plenty of  

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How Does Anesthesia Actually Put You to Sleep?

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    林宜悉 posted on 2020/12/29
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