Very interesting RadioLab discussion. Some graphic descriptions of surgery in the early days in the "Ether Dome"!
And Carl Zimmer's comments about the variability of "awareness" supports the points you were making about "the void"! Splicing two ends of time with no "middle". And anesthesia being more of a switch, as opposed to "sleepiness". Incredibly fascinating, particularly the point of sedation being a "black box", and still being a bit of a philosophical mystery!
Thanks for the insights, Pavulon.
JA
Quote:
Originally Posted by pavulon
Well, I'll try to explain it but the link at the end of my post here is really, really good.
Differing experiences with procedural sedation or anesthesia can be roughly attributed to a few variables but not reliably fully accounted for.
One anesthesia clinician may give only medication X for a procedure on one day and something quite different on another. A different clinician may use a totally different set or amount of medications. The procedure may be more challenging on different days or last longer or be accomplished much more quickly or more simply and require a different amount of sedation or , or... .
There is also considerable variability in patients. People experience things differently. A patient's medical history and age can REALLY alter their capacity to metabolize medications (it's the reason for all the questions asked prior to a surgery or procedure). Each time a person experiences a drug (or anything else, really), they are changed. For medications that is demonstrated most graphically in physical dependence on drugs and more subtly in how people become tolerant to medications over time. An old adage is "enzymes never forget."
Propofol abuse has come forward because the medication is quickly and almost completely metabolized, produces euphoria, is used in HUGE volumes making accounting for it all nearly impossible, troubles in detecting it on routine drug screens and possibly other issues I'm not thinking of right now.
People have been trying to fully explain consciousness and unconsciousness for a LONG time. The Radiolab segment below does a great job of addressing the current understanding of anesthesia and consciousness and how they fit together. It is worth the time to listen but seems to ignore the experiences of people receiving sub-general anesthesia inducing (sedation) doses of medications.
Decoding The Void - Radiolab |