Understanding Of Anesthesia Research Articles

Patients' Perception and Understanding Towards Anesthesia and Anesthetists at Tertiary Care Hospitals of District Mardan: A Cross-Sectional Study from Mardan KP

Background: Anesthesia is integral to patient care during the peri-operative period. Despite advancements, public knowledge about the anesthesiologist's extensive responsibilities and critical role in healthcare remains limited. This study explores the understanding and perceptions of anesthesia and anesthetists among patients at Mardan Medical Complex. Objective: To assess patients’ perceptions and understanding of anesthesia and anesthetists’ roles, identifying factors influencing their knowledge levels. Methods: A cross-sectional study was conducted at Mardan Medical Complex, KP, from June to September 2023. Participants were interviewed using a structured questionnaire that collected socio-demographic data, knowledge about anesthesia, and perceptions of anesthetists. The chi-square test was utilized to explore associations between categorical variables. Results: A total of 309 participants were enrolled, with a response rate of 100%. The demographic breakdown was 159 males (51.5%) and 150 females (48.5%). Only 84 participants (27.2%) demonstrated an understanding of anesthetists’ roles, and 87 (28.2%) claimed knowledge of anesthesia. Significant associations were found between levels of education (p<0.001) and occupation (p<0.001) and the knowledge of anesthesia. Conclusion: There is a marked deficiency in knowledge and understanding of anesthesia and the pivotal role of anesthetists among the patients surveyed. This underscores the need for targeted educational initiatives to enhance patient and public awareness of anesthesiology’s critical functions in healthcare.

Medical students' perspectives on and understanding of anesthesiology: a Canadian cross-sectional survey.

In Canada, three out of 17 medical schools do not mandate an anesthesia rotation in their clerkship curriculum. Understanding the effects of a mandatory anesthesiology rotation is important in determining its value to the specialty and guiding decision-making for medical educators.We sought to determine whether a mandatory anesthesia rotation affected students' understanding of anesthesiology, as well as their perspectives on anesthesia. We conducted an anonymous cross-sectional survey of Canadian medical students graduating in 2021. Our survey consisted of 46 questions related to student's perspectives of anesthesiology, understanding of anesthesia, their interest in the specialty, and participant's demographics. This included 16 Likert-scale questions, 19 quiz-style questions, four free-text response questions, and seven demographics questions. The survey was hosted by SurveyMonkey® (SurveyMonkey Inc., San Mateo, CA, USA) and distributed to the participants by each individual institution. We collected a total of 331 responses across 13 different Canadian medical schools, representing a 17.3% response rate of students surveyed and 11.7% of all graduating medical Canadian students in 2021. A mandatory rotation in anesthesiology was associated with a more positive perspective (P = 0.01) but not understanding (P = 0.07) of the specialty. A mandatory rotation was not related to students' application to anesthesiology at a statistically significant level (P = 0.06). The results of this national survey study show the benefits of including a mandatory clerkship rotation in anesthesiology, namely on increasing positive perceptions of the specialty, while also revealing avenues for future research and insights on how to further optimize a mandatory anesthesiology rotation in clerkship.

Demystifying the role of anaesthetists in clinical coding in the Australian healthcare system.

Despite the self-evident importance of hospital funding, many anaesthetists remain unsure of exactly how their daily work relates to hospital reimbursement. A lack of awareness of the nuances of the Australian hospital activity-based funding system has the potential to affect anaesthetic department reimbursement and thus resourcing. Activity-based funding relies on clinical coders reviewing clinical documentation and quantifying the care given to a patient during an admission. Errors in funding allocation may arise when there is a disconnect between the work performed and the information coded. In anaesthesia, there are several factors impeding this process, including clinical understanding of coding, system setup and coders' understanding of anaesthesia. This article explores these factors from the clinical anaesthetist's point of view and suggests solutions, such as awareness and education, clinician-coder cooperation and redesign of documentation systems at a systems level that anaesthetic departments can incorporate.

The Empathic Patient Centered Approach in the Anesthetic Preoperative Interview

Background: Multiple studies in the primary care field have indicated the benefits of using a patient centered approach in communication with the patient; such interviewing methods have been shown to improve patient satisfaction and adherence. There is a scarcity of anesthetic literature regarding communication skills in the perioperative period. The goal is to analyze to what extent empathic patient-centered communication methods are being used by anesthesia providers. Communication scores will be compared among providers, as well as to providers across several different subspecialties. Methods: This study is an observational descriptive study at a large tertiary care center, University Hospital in Newark, NJ. The observer observes and grades patient interviews, scoring against established criteria using an adapted version of the Kalamazoo grading tool. The researcher observes and grades the preoperative interview using the adapted Kalamazoo scale. At the end of the observed encounter, the anesthesia providers are asked to fill out a brief form detailing their demographic history, details regarding the providers’ length and type of clinical education and training, undergraduate education, previous communication training, number of years of practice, primary language, gender, and age will be obtained. Results: Anesthesia providers included in the study were physician anesthesiologists, residents, and nurse anesthetists. The average Kalamazoo score was 28.7 amongst all providers. There was no significant effect of provider level on the score at the p Conclusions: The data revealed anesthesia providers provide patient-centered encounters with a mean score of 28.7, which is higher than the average for providers from multiple different specialties observed in Joyce, et al. study (mean score of 25.25). The subcategories “Understanding patient’s perspective” and “reaches agreement” scored 3.86, and 3.83, respectively. This may indicate that anesthesia providers can improve on allowing the patient to communicate their understanding of anesthesia, as well as collecting information from the patient that can affect their anesthesia (i.e., severe nausea following previous anesthesia).

Ion Channels in Anesthesia.

Ion channels play a pivotal role in anesthesia, including general and regional anesthesia. Two main classes of general anesthetics (GAs) are inhalational anesthetics, such as isoflurane, sevoflurane, and nitrous oxide; injectable anesthetics, such as propofol, etomidate, and ketamine. Besides hypnotic agents, muscle relaxants for immobility and opioids for analgesia are needed to achieve balanced anesthesia. Although our understanding of anesthesia is far from complete, recent studies have revealed the molecular interactions between anesthetic drugs and ion channels, particularly, the ligand-gated ion channels (LGICs). Ionotropic GABAA receptors (GABAARs), the main mediators of the inhibitory signals in the central nervous system (CNS), are the key to hypnosis by general anesthetics. Ionotropic cholinergic receptors (nAChRs), expressed at the neuromuscular junction and the nervous system, are the molecular targets of muscle relaxants. GABAARs and nAChRs belong to the same family of pentameric LGICs. With a completely different architecture, ionotropic glutamate receptors (iGluRs) carry the excitatory signals in the CNS and are targeted by inhalational anesthetics and ketamine. Another distinct family of ion channels, two-pore-domain K+ (K2P) channels, can be activated by inhalational anesthetics and cause neuron hyperpolarization. In this chapter, we will discuss the recent advance in understanding the molecular mechanisms underlying anesthesia through the molecular structures of these ion channels.

Anesthesia Lost in Translation: Perspective and Comprehension

Care of non-English speaking patients poses a unique challenge to the anesthesiologist in the perioperative setting. Communication limitations can be frustrating to both the patient and provider, and at times can compromise the quality of care, resulting in health care disparities. An often overlooked, but critical component is the interaction between the anesthesia provider and the interpreter. The goal of our study was to identify misconceptions regarding anesthesia and determine common knowledge gaps amongst medical interpreters. A survey inquiring about past perioperative experiences, level of training, and barriers to effective communication was sent to the Department of Interpreter Services (IS). Concurrently, a survey was sent to the Department of Anesthesia, about their experiences with interpreters in the perioperative setting. Our survey had 29 respondents from IS and 42 respondents from Anesthesia. 85% of interpreters had >5 years experience, but 96% denied having anesthesia specific training. Additionally, 42.5% of our interpreters felt that less than half of their patients were sufficiently literate to read and consent in their native language. Anesthesia providers were primarily concerned about the fidelity of the interpretation. Misunderstanding one another's field appears to play a significant role in the communication issues surrounding interpretation for anesthesia. Educating both departments may prove beneficial to resolving misconceptions, improving perioperative interactions and ultimately improving patient care. Based on the gathered information, a continuing education lecture was created by the Anesthesia Department in order to improve our interpreters' understanding of anesthesia, associated procedures and vocabulary.

An Update on the State of Clinical Neuroscience of Anesthesiology

The FAER-Helrich Research Lecture focused on how neuroscience research is rapidly changing our understanding of anesthesia and how a deeper understanding of neuroscience can change patient care. Specific topics include the neural circuit mechanisms of commonly used anesthetics, electroencephalogram (EEG) signatures, how EEGs and their spectrograms can be used to track the state of anesthesia, how to control sedation, and how the brain dynamics under anesthesia change with age.

Irish Medical Students Knowledge and Perception of Anaesthesia

Background : Medical students are often considered by anaesthetists to have a lack of knowledge of anaesthesia and the role of the anaesthetist. Aim : The aim of this study was to assess the impact of a clinical clerkship in anaesthesia on Irish medical students understanding of anaesthesia as a specialty, the role of anaesthetists and career choice through comparison of pre-clinical and clinical medical students. Methods : This was a cross sectional study of 80 Irish medical students who completed an anonymous questionnaire consisting of 16 items. Results : Only 47.5% of clinical students were aware that anaesthetists participate in running intensive care units and just 65% knew that anaesthetists were involved in the management of chronic pain. However, 100% of clinical students recognised that anaesthetists administered epidural analgesia to obstetric patients and 30% of clinical students would consider a career in this specialty. Conclusion : This research is providing medical professionals and educators with updated information which may be useful for improving students experience and understanding of anaesthesia.

Survey on understanding after anesthetic induction simulation training in medical students' anesthesiology practice

Survey on understanding after anesthetic induction simulation training in medical students' anesthesiology practice

Developing new neurophysiological signatures of general anesthesia induced loss of consciousness

General anesthesia is currently defined in the context of its use in clinical care [1]. The mechanism by which anesthetic drugs induce general anesthesia is not well understood. There is therefore a need to incorporate neurophysiological characterizations into the definition and understanding of anesthesia. Distinct patterns in the electroencephalogram have been associated with anesthesia-induced loss of consciousness [2-4] and are used as part of protocols to monitor integrity of brain function [5]. However, the transition to unconsciousness during a gradual induction of general anesthesia has not been studied systematically.

Anesthesia and the Meyer-Overton Rule II. A Solution Theory View of Anesthesia and Perturbations

Solution theory arguments play a significant role in the analysis of general anesthesia. However, the results are of limited value, due to the complexity of the systems to which these arguments are applied. This article suggests that we can advance our understanding of anesthesia by the analysis of a solution of hard spheres as an "ideal anesthetic medium". We obtain a precise definition of perturbation, which links together its structural and thermodynamical aspects in an accurate theory. It follows that this link applies to virtually all material systems, including the complex biological systems where anesthesia occurs. The derived relations: (i) explain the unique role of helium in hyperbaria; (ii) suggest how to establish a hierarchy of importance among possible causes of anesthesia; (iii) indicate the role of the Meyer-Overton rule in analyzing structural models of anesthesia; and (iv) depict the physical meaning of correlations, commonly used in anesthetic work, and show why they are more accurate than the Meyer-Overton rule.

The anesthetic site of action: from the intact brain to the isolated protein. An overview

To the present day there is no consensus of opinion as to which molecular events lead to the complex clinical state generally referred to as anaesthesia. The multitude of simultaneous physiological changes are also responsible for this lack of consensus. During anaesthesia, for example, consciousness, perception, memory, pain, and muscle relaxation are altered. The actions of anaesthetics correlate very well with their partitioning into lipophilic phases. Lipophilic interactions are non-specific. Therefore, it is likely that anaesthetics act at many different sites. Cell membranes are not the only possible sites but also membrane proteins and the various hydrophobic domains they contain. The multitude of clinical anaesthetic effects is paralleled by the complexity of molecular interactions. A better understanding of anaesthesia requires an integrated view of anaesthetic effects at the various systemic levels, beginning with the molecular domain and ending with the intact central nervous system. Anaesthesia research could be directed more towards man because it has now become possible to conduct molecular in-vitro studies with human cells as well as non-invasive studies of the intact human central nervous system.