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?
Lv 4
? asked in Science & MathematicsMedicine · 1 decade ago

Why do most people experience amnesia following general anesthesia, while others experience none at all?

Is this simply individual variability in tendency to cognitively rehearse what is said following the procedure requiring anesthesia? Perhaps, this in combination with willingness to feel vulnerable, or to trust? Just some thoughts. But, does anyone know why it seems that the majority of people have difficulty or can not recall events following general anesthesia, while there are a few outliers who recall everything?

Update:

Thanx, Pangolin :-). I've read that IV induction agents are most often propofol, sodium thiopental, etomidate, and ketamine. Read about Mitozolam during maintenance and pre-sedation/-mediation, only.

Is there a typical anesthetic given for surgeries and procedures that wouldn't involve a person needing to be "conscious"? Are you saying it is indeed Midazolam?

Update 2:

Sorry, above, I didn't finish my thought. I meant to ask if either the absence of Mitazolam or its underdosing may very well explain why few people appear to be outliers in not experiencing amnesia. Sounds plausible.

I wasn't, however, referring to patients who aren't adquately informed about the effects of the medication they are being given, so can only report erroneous belief.

Update 3:

Pangolin, I don't know if you tend to check back on your answers. But, that rambling above does not communicate what I wanted to ask you. Too bad on can't edit "additional details". Anyway, please excuse me.

I wondered whether the Mitozolam was a common drug used in induction (if my info was incorrect)? And, whether it was typically a part of most anesthetic procedures (not requiring consciousness)?--I just curious why it would be left out in some cases.

Also, how does one choose between the induction agents. Is there something typical used depending on a set of typical factors?

Too many follow-up Q's, I suspect and, I know, totally not to do with my original Q ;-) :-).

Update 4:

Oh, thanx, SAMI. So, I guess one may need to be given more than one dose for the amnesia to be "worse"? Perhaps, a function of the length of surgery? I am really not informed in this area.

I may head off to Pubmed, later, to satisfy much of my curiosity, here. There must be some studies published about this. I just figured there was a simple explanation such as that I provided in my original Q ;-) :-).

2 Answers

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  • Pangolin
    Lv 7
    1 decade ago
    Favorite Answer

    Most people are amnestic because we give them drugs specifically for that purpose, midazolam being the most effective. The potent inhalation agents also have some amnestic properties if the end-tidal concentration is high enough.

    Outliers most likely were not given midazolam, or had lower than normal concentrations of potent inhalation agents given. Many patients who report awareness were not actually given a general anesthetic (I can't tell you how many elderly patients report awareness during their cataract surgeries - they're SUPPOSED to be awake for those!). Others are just plain underdosed.

    There appear to be a very few individuals who are resistant to the amnestic effects of anesthesia, and I have no idea why. I don't think anybody knows.

  • ?
    Lv 7
    1 decade ago

    Pre anesthetic medication like Alzolam has an amnesic effect but not with a single dose. Post anesthetic amnesia like alcoholic amnesia occurs in older people and in those who undergo repeated surgeries under GA.

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