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anesthesia

Absence of sensation, or a procedure to induce the absence of sensation. Indications: - surgical procedures - acute pain, not manageable by other means Adverse effects: - general anesthesia (single exposure) < 4 years of age is not associated with cognitive impairment in adolescence. [3] Laboratory: - microtubule associated protein tau in serum - increases to peak levels 6 hours postoperatively - decreases - neurofilament light chain in serum increase for > 48 hours postoperatively * mix of general anesthesia & regional anesthesia [5] * fentanyl used in all patients * clinical significance unknown [5] Notes: - anesthesia transition of care mid-surgery associated with poor outcomes (combined mortality, hospital readmission, & major complications within 30 days) 44% vs 29% with continuity of care [4] - poor communication may play a role

Related

anesthetic

Specific

general anesthesia local anesthesia regional anesthesia; spinal anesthesia; neuraxial block

General

clinical procedure

References

  1. Clinical Anatomy Made Ridiculously Simple. Stephen Goldberg, MedMaster Inc, Miami, 1995
  2. Hawkins JL. American Society of Anesthesiologists' Practice Guidelines for Obstetric Anesthesia: update 2006. Int J Obstet Anesth. 2007 Apr;16(2):103-5. Epub 2007 Feb 12. PMID: 17293104
  3. Glatz P, Sandin RH, Pedersen NL et al. Association of anesthesia and surgery during childhood with long-term academic performance. JAMA Pediatr 2016 Nov 7; PMID: 27820621 - Hansen TG, Engelhardt T, Weiss M. The relevance of anesthetic drug-induced neurotoxicity. JAMA Pediatr 2016 Nov 7 PMID: 27820616
  4. Lou N. Anesthesia Care Hand Off Mid-Surgery Associated With Substantial Risk - Poor communication the presumed reason. MedPage Today. January 09, 2018 https://www.medpagetoday.com/surgery/generalsurgery/70379
  5. Evered L, Silbert B, Scott DA, Zetterberg H, Blennow K. Association of changes in plasma neurofilament light and tau levels with anesthesia and surgery: Results from the CAPACITY and ARCADIAN studies. JAMA Neurol 2018 Feb 19; PMID: 29459944