Can patients communicate with the anesthesiologist and surgeon during general anesthesia? Well, thanks to a new "cooperative patient" anesthesia technique, says an Italian study.
The researchers, led by Dr. Sergio Bevilacqua of Ospedaliera Universitaria Careggi, Florence, used their "cooperative patient general anesthesia" technique on 181 patients undergoing carotid artery surgery (endarterectomy) for stroke prevention.
The new study has found cooperative patient general anesthesia to be a "safe and satisfactory" technique for use in carotid surgery.
By allowing the patient to respond to simple commands, it provides the surgeon with valuable information to guide the procedure.
The researchers said that the procedure was apparently safe, pain free, and not disturbing or traumatic for the patient.
During the study, the patients received conventional general anesthesia up to the time that the carotid artery was clamped, which is done for allowing the surgeon to repair it.
At that time, the researchers reduced the general anesthetic, and the patients received an infusion of remifentanil, a morphine-like drug that suppresses pain but permits the patient to regain consciousness.
This allowed the patients to respond to simple commands, such as to open their eyes or squeeze a toy in their hand, thus allowing the surgeon to verify that the blood supply to the brain remained adequate during surgery.
The cooperative technique was successfully carried out in all but two patients, who were kept on general anesthesia, while all of the remaining patients could respond to the surgeon's commands.
In about twelve percent of cases, the responses from the conscious patient led the surgeon to take additional steps to protect the brain blood flow.
Most patients reported no problems with related to being conscious during their surgery. Ninety-nine percent of patients found the experience nonstressful, sometimes even pleasant.
Most described the experience as dreamlike, while some had more vivid recollections.
None reported any pain or distress, and thus both patients and surgeons were happy with the anesthesia technique.
The study has been published in the journal Anesthesia and Analgesia.