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General Anesthesia is a Reversible Coma, Not Sleep, Researchers argue

The Boston Globe (12/29, Cooney) "White Coat Notes" blog reported, "Every day about 60,000 Americans go under general anesthesia before surgery." Their physicians "probably told them they'd be 'going to sleep' for the duration of the operation, but calling it a 'reversible coma' is closer to the truth, a Boston anesthesiologist argues in" an article in the Dec. 30 issue of the New England Journal of Medicine. "Dr. Emery Brown of Massachusetts General Hospital and his colleagues say it's an important distinction to make for two reasons: to be honest with patients and to open up a dialog among doctors about insights into other branches of medicine that can be gleaned from anesthesia."

In their article, researchers "compared the physical signs and brain patterns of those under anesthesia and those who were asleep," HealthDay (12/29, Dotinga) reported.

Medscape (12/29, Brooks, subscription required) reported that the investigators found "substantial overlap between the electroencephalograms of patients in coma and of patients during general anesthesia." Dr. Brown noted, "The [electroencephalogram] of the states of coma recovery can resemble those of the awake, general anesthesia, or sleep state, depending on how extensive the brain injury is and where the patient is in terms of recovery." Notably, "general anesthesia, the scientists say, is functionally equivalent to brainstem death, and perhaps explains why some patients do not fully recover consciousness for several hours after general anesthesia, as well as why postoperative cognitive dysfunction could persist in elderly patients for several months afterward."