麻醉过程中意识和记忆的认知神经生物学——科学的可能性和临床意义

Berenika Maciejewicz
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引用次数: 0

摘要

药物诱导的无意识状态,使病人对不舒服的手术刺激没有反应,被称为全身麻醉。当它用于手术时,可能会出现一种相当罕见但具有创伤性的状态,即麻醉意识。患者在手术过程中能够保持清醒、意识清醒、能够听到周围的声音并经历剧烈的疼痛,但却无法与外界交流的可能性有多大?据估计,每1000例患者中有1 ~ 2例在全身麻醉后出现这种现象并保留各种感觉信息。即使在看似有效的麻醉护理下,麻醉过程中出现的意识状态也经常伴随着不同程度的记忆丧失机制。一些研究人员和本文中涉及的实验表明,麻醉仅仅是在事件本身引起的记忆丧失或尚不清楚的神经学形式的健忘症,而不是在创伤事件中意识丧失本身,正如本文所描述的研究所表明的那样。在某些情况下,这种痛苦可能是无法忍受的,并伴有长期的神经精神影响,如创伤后应激障碍。虽然麻醉期间意识恢复的神经生物学现象仍然知之甚少,但这些不断报道的事件具有重要的医学和法律后果。本研究收集、分析和讨论了可能增加术中意识水平升高风险的众多因素。还讨论了诱导前和术中使用的预防方法,以及发生此类事件后采取的纠正措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cognitive Neurobiology of Consciousness and Memory during Anesthesia Awareness—Scientific Possibilities and Clinical Implications
The condition of pharmacologically induced unconsciousness that renders a patient unresponsive to uncomfortable surgical stimuli is known as general anesthesia. When it is used for surgery, a fairly rare but traumatizing state known as anesthesia awareness might develop. What is the probability that a patient can be awake, conscious, and able to hear the surroundings and experience excruciating pain but be immobilized to communicate it during surgery? According to estimates, there are 1 to 2 cases for every 1000 patients who experience this phenomenon and retain various sensory information after general anesthesia was applied. Even with seemingly effective anesthetic care, emerging consciousness states during anesthesia are reported and often come with various degrees of memory loss mechanisms. Some researchers and the experiments covered in this paper suggest anesthesia is merely a memory loss or poorly understood neurological form of amnesia induced during the event itself and not a loss of consciousness per se during the traumatic event, as suggested by studies described in this article. In some instances, the agony may be unbearable, with long-term neuropsychiatric effects such as post-traumatic stress disorder. Although the neurobiological phenomenon of consciousness regained during anesthesia is still poorly understood, these continuously reported events carry significant medical and legal ramifications. The numerous contributing elements that may increase the risk of intraoperative raised levels of consciousness are gathered, analyzed, and discussed in this research study. Preventive methods for both preinduction and intraoperative usage, as well as corrective actions to take after such occurrences, are also discussed.
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