Show What A I Mention the word and nd the ordinary citizen conjures up a hackneyed hackneyed hackneyed hack hack- cartoon of a medic with witha a can of ether in one hand and anda a rag in the other THE TilE CARTOON is actually a statement of misinformation and irony for is isa isa isa a complex and demanding pro pro- Although doctors use dozens of chemical agents to produce anesthetic vapors they know as little about why people go to sleep under an anesthetic as country doctors did years ago All AU we know is that the patient is asleep and feels no pain says Dr Ueda a year 10 veteran of anesthetic research at the University of Utah He says there are many hypotheses about what happens hap hap- pens that pens that there is a biochemical biochemical biochemical bioche bioche- mical change or a change inthe in inthe inthe the physical chemistry of the body or in its logy logy but but no one really knows Im scratching the corner on that one now he remarked THIS TillS ASSISTANT research professor says anesthesiologists have come a long way since their counterparts knocked knock knock- ed patients unconscious centuries centuries cen cen- tunes ago by hitting them on the head frequently producing brain concussions which claimed claimed claimed claim claim- ed many many lives Then about abou t years ago physicians bega be be- ga ga j using the ether et t the g I same time that chloroform appeared appear appear- ed in England But Dr Ueda says that although patient monitoring has become very sophisticated and technology has improved there has been no major breakthrough in theory What is puzzling says Dr Ueda is that if a surgeon surgeon surgeon sur sur- geon operates on a person who is in a deep natural sleep he awakens immediately immediate immediate- ly yet he will feel nothing if he is anesthetized and we haven't the slightest idea why MOST PEOPLE dont don't understand understand understand under under- stand the complexity of anes- anes according to the U researcher A patient undergoing undergoing undergoing under under- going an operation is given a mild sedative in pill form and often oHen believes the shot which follows usually follows usually sodium pento- pento thal thal-is thal is the final agent admin admin- Actually sodium pen- pen is only a mild anesthetic tic which is followed by a variety variety variety var var- of chemical vapors to keep the patient unconscious The profession is especially complicated says Dr Ueda since all anesthetics are toxic The surgeons are trying to cure their patients w with th drugs and were we're admi administering n i s t e r i n g poison to put them to sleep ALTHOUGH anesthesiologists have reliable signs to watch for during an operation pulse pulse rate respiration and blood pressure they pressure they are extremely extremely extremely ex ex- primitive Were still trying to find a better way to check the depth of or the anesthetic anesthetic anes anes- anesthetic says Dr Ueda If It we could measure the depth of sleep with an EEG electroencephalogram electroencephalogram electroencephalogram electro electro- encephalogram we could develop develop develop de de- de- de a machine to administer anesthetics p pre predicts r e d i c t s Dr Ueda But he says there is much controversy about the accuracy of brain activity to the depth of sleep The U scientist is interested in what enzymatic sequences take place before a person is unconscious He believes that normal sl sleep ep and sleep under an anesthetic are qualitatively different THERE ARE two stages of or normal sleep the shallow stage when a person first goes to sleep followed by the deep or dreaming stage during which REM rapid eye movement movement movement move move- ment occurs The deep stage is required for body repairing says D Dr Ueda and if a person is awakened during this stage he is irritable and exhausted Researchers have been unable unable un un- able ablo to identify either of the two cycles during anesthesia but if a chemical agent could I be developed to produce normal normal normal nor nor- mal sleep cycles a patient would awaken refreshed instead in instead in- in instead stead of exhausted WERE ALWAYS working on new drugs to make them safer and more controllable says Dr Ueda but the end goal is to develop an agent which stops pain sensation doesn't affect the respiratory or cardiovascular s system y s t em e m. m That kind of bl bi would reduce the danger of anesthesia to near zero |