User:Kaitlynkr/General anaesthesia

These are some references from my bibliography:

Articles about anesthesia effects on children:

 * Clemson University Libraries - Login, https://web-s-ebscohost-com.libproxy.clemson.edu/ehost/pdfviewer/pdfviewer?vid=0&sid=6458647c-e39a-4134-bafc-5663667557d1%40redis.
 * This journal article discusses anesthesia being used on children and all the decisions that need to be made.
 * Some decisions include, wether or not to ventilate the child.
 * The article states, "The Lancet Commission on Global Surgery reports that 5 out of every 7 people in the world lack access to safe, affordable, and timely surgical care"
 * Children make up the largest group of those who lack good healthcare.
 * Some essential equipment is not available in some places for anesthesia
 * example of essential equipment:intubation aids, suction device, oxygen concentrators, and physiological monitors.
 * Urfalioglu, Aykut, et al. “Anesthesia Procedure for Congenital Insensitivity to Pain in a Child with Anhidrosis Syndrome: A Rare Case.” Journal of Nippon Medical School, The Medical Association of Nippon Medical School, 16 Nov. 2017, https://www.jstage.jst.go.jp/article/jnms/84/5/84_237/_article.
 * This journal article talks about a rare case of administering anesthesia on a child.
 * Congenital insensitivity to pain with anhidrosis (CIPA) is a condition where a person has no sensitivity to pain, sweats excessively, and has mental retardation.
 * The article talks about how there is still pain in a procedure even if the patient has this condition. Anesthesia still needs to be administered.
 * Because of the nature of this condition, doctors must make important decisions on how to administer anesthesia and what needs to be closely monitored. For example, what kind of drugs need to be used, how strong should the anesthetic be? Body temperature is also something that is heavily monitored for patients with this condition.

Articles about anesthesia effects on the brain:

 * Rasouli MR;Kavin M;Stache S;Mahla ME;Schwenk ES; “Anesthesia for the Patient with a Recently Diagnosed Concussion: Think about the Brain!” Korean Journal of Anesthesiology, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/31257815
 * This article talks about how anesthesia affects the brain when a patient has a concussion.
 * there is some risk with using anesthesia when someone is concussed- can lead to further brain injury
 * concussions create ionic shifts in the brain that adjust the neuronal transmembrane potential. In order to restore this potential more glucose has to be made to equal the potential that is lost. This can be very dangerous and lead to cell death. This makes the brain very vulnerable in surgery.
 * There are also changes to cerebral blood flow. The injury complicates the oxygen blood flow and supply to the brain.
 * Smith, D.I., Mills, J. H. (1989), Anesthesia Effects: Auditory Brain-Stem Response. Electroencephalography and Clinical Neurophysiology , 72(5), 422-428.
 * This article from google scholar talks more about the brain and anesthesia..
 * It mainly discusses how some of the drugs used in anesthesia can effect auditory brain stem response.
 * Barbiturates overall do not effect auditory brain stem response.
 * Studies were done on rats in particular. ketamine was given to them and there was no significant change to brain response.
 * Minor changes in latency and amplitude of ABR occurred with ketamine in a similar way hypothermia affects the brain.

Article body
Anesthesia has little to no effect on brain function, unless there is an existing brain disruption. Barbiturates, or the drugs used to administer anesthesia do not effect auditory brain stem response. An example of a brain disruption would be a concussion. It can be risky and lead to further brain injury if anesthesia is used on a concussed person. Concussions create ionic shifts in the brain that adjust the neuronal transmembrane potential. In order to restore this potential more glucose has to be made to equal the potential that is lost. This can be very dangerous and lead to cell death. This makes the brain very vulnerable in surgery. There are also changes to cerebral blood flow. The injury complicates the oxygen blood flow and supply to the brain.