Does anesthesia affect memory? How important is the anesthesiologist's role during surgery?

In our lives, we may have heard of anesthesia to some extent. Whether we are having surgery ourselves or our family members are having surgery, anesthesia is indispensable. When hearing about surgical anesthesia, many people's first reaction is whether anesthesia will affect memory? Some people firmly believe that anesthetics damage memory, while others think that the impact is minimal. So, can anesthesia really affect memory? What is the important role of anesthesiologists in surgery? This article will give you a simple popular science.

1. Definition of Anesthesia

Anesthesia is the use of drugs or other methods to temporarily make the patient lose consciousness in order to achieve a painless state and provide the necessary conditions for surgery or other medical examinations. Anesthesia techniques are divided into two categories, one is local anesthesia and the other is general anesthesia. The so-called local anesthesia is to block the nerve conduction process through drugs, and produce anesthesia effects on certain parts of the body while ensuring that the patient is awake. The so-called general anesthesia is to inject or inhale anesthetics intravenously to make the patient enter an unconscious state, thereby completely eliminating pain and discomfort. In modern anesthesia technology, anesthesia is not only for pain relief, but more importantly, to ensure the safety and comfort of the patient. Before surgery, the anesthesiologist must fully assess the patient's condition, choose the appropriate anesthesia method and medication to ensure that the patient's vital signs are stable during the operation and reduce the risk of surgery.

2. Does anesthesia affect memory?

① Research on local anesthesia and memory

Local anesthetics generally only work on the nerves in the surgical area, blocking the conduction pathways of the nerves, causing the patient to lose any sensation in the area where surgery is required. However, local anesthetics do not enter the brain, so the effects on the central nervous system are negligible, and there is no significant effect on memory. When patients are under local anesthesia, they usually remain conscious and can clearly recall the entire surgical process and all the details before and after the operation.

② Research on general anesthesia and memory

General anesthesia is a method that involves more nervous system suppression. It combines the combined effects of multiple drugs such as sedatives, analgesics, muscle relaxants and inhaled anesthetics. These drugs begin to work and metabolize in a very short time, and are generally excreted from the body within a few hours after the operation is completed. When performing general anesthesia, anesthetics may have a depressant effect on the central nervous system, causing the patient to temporarily lose consciousness and have no memory of the operation. However, this effect is very short-lived and can be reversed. As the body gradually metabolizes and excretes the anesthetic, the patient's consciousness and memory will gradually recover.

3. The role of anesthesiologists in surgery

①Do a good job of preoperative evaluation and communication

Anesthesiologists play a very important role before surgery. They need to conduct a detailed full-body examination of the patient and have an in-depth understanding of the patient's medical history, current medication, and possible risk factors, so as to help doctors predict and avoid possible complications. At the same time, anesthesiologists can not only understand the patient's condition but also the patient's psychological condition through detailed communication with the patient, so as to choose the best anesthesia method and medication for the patient. This personalized treatment plan is designed to minimize surgical risks to ensure the safety and comfort of the patient.

② Guard the patient throughout the process

There are many types of anesthesia. The best anesthesia method should be determined based on the patient's basic physical condition, disease condition and surgical method. General anesthesia can be divided into three stages: induction, maintenance and awakening. During the induction of general anesthesia, the anesthesiologist will first open the patient's peripheral veins for basic monitoring. When the general anesthetic is infused through the newly opened vein, the patient uses an oxygen mask to inhale 100% pure oxygen. During the induction of general anesthesia, the patient quickly falls asleep, the muscles of the whole body are completely relaxed, and they cannot breathe independently. The anesthesiologist will intubate the patient and insert a ventilation tube into the patient's trachea. This tracheal tube can connect the patient's airway to the external ventilator to ensure that the patient can ventilate through the ventilator and provide the body with enough oxygen. In addition, the anesthesiologist also needs to flexibly adjust the dosage of anesthetics according to the progress of the operation and the patient's immediate response, in order to achieve a safe and effective anesthesia effect. Professional judgment and quick response are important guarantees for the success of the operation.

③ Comprehensively monitor the patient’s vital signs

After the induction period of anesthesia, the patient can undergo surgery. The anesthesiologist cannot completely relax at this time, but must accompany and monitor the patient throughout the whole process. This stage can also be called the anesthesia maintenance period. During this period, the anesthesiologist needs to fully monitor the patient's vital signs, such as blood pressure, oxygen saturation, body temperature, etc.; in addition, it is also necessary to monitor the changes in arterial blood pressure, pulse volume, arterial blood gas, esophageal ultrasound, etc. in real time. At the same time, sedatives, analgesics, muscle relaxants, etc. must be supplemented in time to ensure that the patient can maintain a stable state of vital signs during the operation and will not suffer any harm caused by adverse stimulation.

④Postoperative care and rehabilitation

When the patient's surgery is completed, but the anesthesia is not over, this is the third step of anesthesia, anesthesia awakening. During this period, the anesthesiologist must allow the patient to wake up smoothly from the anesthesia state, and the muscles of the whole body must also recover from the relaxed state to the normal functional state, so as to ensure that the patient can breathe independently and maintain the oxygen supply of the whole body. The withdrawal time is half an hour to an hour. From the withdrawal of the drug to the complete awakening, the patient's consciousness is clear, and simple questions can be answered correctly, the airway is unobstructed, the throat reflex is restored, and the muscle strength is normal. It usually takes half an hour to an hour. If the awakening delay exceeds this time, the anesthesiologist will find out the reason and take effective treatment measures. In addition, the anesthesiologist must pay close attention to postoperative recovery, especially the recovery of cognitive function. Some patients, especially elderly patients or those with cognitive impairment before surgery, may have temporary cognitive impairment after surgery. In this regard, the anesthesiologist should intervene in time and give targeted rehabilitation guidance.

Conclusion

In conclusion, the relationship between anesthesia and memory is a complex issue that is influenced by multiple factors. Although anesthesia may temporarily affect short-term memory, this effect is short-lived and reversible. For most patients, their memory function can quickly return to normal after anesthesia and will not cause long-term interference in their daily life. Therefore, do not worry too much about the adverse effects of anesthesia on memory.

Author: Song Xi, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University