In kids, EEG monitoring of consciousness safely reduces anesthetic use
14 comments
·April 30, 2025crazygringo
quantumwoke
My wife is a doctor and provided me (layperson) the following context. Apparently EEG is now used in most adult surgeries and has been increasing over time. It is used as a marker of how 'asleep' you are to guide how much medication you get. However, this is relatively recent and the use of EEG in kids (where the brainwaves are different) was not studied/used as much. It seems like this study pushes towards a future where EEGs are routine in most if not all surgeries to make them safer - especially as the next generation of anaesthetists are trained in it.
Etheryte
If the reporting is accurate, which is really not a given with MIT, this is great news. For all its upsides, general anesthesia is still dangerous and very rough on you, and all these effects are always amplified for young patients.
louthy
> very rough on you
How so?
Etheryte
To start, the article gives a few good examples:
> children sometimes wake up from anesthesia with a set of side effects including lack of eye contact, inconsolability, unawareness of surroundings, restlessness, and non-purposeful movements
In general, a very simple mental model for general anesthesia is that it's an unnatural state for your body and your body will do its best to get rid of it, similar to say alcohol or drugs. This means systemic inflammation, stress on your cardiovascular system, liver and kidneys, brain, and so forth. Most all of these issues scale with how much anesthetic you receive, similar to a hangover being worse the more you drink.
In other words, general anesthesia is rough on you just like getting black out drunk is, it's just more controlled and we do our best to try and limit the downsides because it's invaluable for surgery where applicable.
logifail
> In other words, general anesthesia is rough on you
Can confirm having watched our kids recover from general anesthesia multiple times.
Full disclosure: have three kids, eldest child at lifetime total of 4x general anesthesia so far (1x for endoscopy, 3x for surgery), youngest child lifetime total of two (1x endoscopy, 1x dental work). Middle child seems to have escaped so far... he asked recently what it was like, siblings answered unanimously - "terrible".
Nezghul
What is the level of unconsciousness during anesthesia? Is it "sleep-like" unconsciousness or "neurons do basically nothing" level? Whenever I read about anesthesia I am wondering if we are not accidentally killing people (and creating new ones) like in teletransportation paradox. https://en.wikipedia.org/wiki/Teletransportation_paradox
accrual
Just anecdata, but I was under a few times as kid. It was like teleporting into the future. Last memory was being told to count backwards, next memory was waking up in the recovery room.
Apparently I had a small anesthetic overdose in the hospital as a kid and woke up a day or two later than expected, but from my perspective, nothing happened and I just went to sleep then woke up.
holowoodman
"Kids don't need anesthetics. If they are young enough, they won't remember the pain, so you can just operate without anesthetics. They are also easier to restrain than adults."
This was state of the art in medicine for quite some time. I fear the general trend of "medication bad" will get us back to those dark times.
Btw, those dark times ended only as recently as 1987! https://www.newsweek.com/when-doctors-start-using-anesthesia...
quantumwoke
My wife is a doctor and looked into the history of this for a bit more context. Apparently, there were some cases in 1987 where premature neonates were paralysed but not given general anaesthesia due to risk of immediate death. There was a position statement from the paediatric society at the time that nobody should be operated on without anaesthetics.
Note that this does not mean that general anaesthesia was not given at all to kids before 1987, but that there was a belief in the USA (and elsewhere) that newborns did not need pain relief during anaesthesia. Your use of 'kids' versus 'newborns' is a bit misleading in that respect.
throwanem
This research is aimed precisely at making it safe enough to administer general anesthesia in these populations for that to become standard of care.
Let me preempt one possible line here: I do not love the circumstances under which I would have been circumcised as a neonate in Mississippi in the very early 1980s, and I do not resent the result. Living that far tied up in the past is for men who can't figure out how to do anything else. I am not one of those and despite an essential sympathy with the theoretical basis of their position that no putative benefit remotely justifies the the risk of the intervention, I have a short way with "intactivists."
But if it had been possible safely to administer more than EMLA (perhaps!) for pain relief, not even in that place and time would anyone be so barbaric as to refuse it. Of course. And that, making possible that precise measure of mercy in the case where the intervention is not merely cosmetic, is exactly that at which this research is directed. So, to anyone looking to make a cause of the ghosts of a billion foreskins or whatever, I would say please do not attempt even by implication to recruit my argument in support of your position.
holowoodman
I didn't say anything about a foreskin anywhere. And my point is, they did not just do minor stuff like a circumcision (which I think is a barbaric, pointless and immoral practice to inflict on non-consenting minors in any case except to maybe cure phimosis).
They did major surgery. Like opening the cranium or abdomen. Like removing limbs. Like removing burnt skin by brushing it off and applying skin grafts. And no, they didn't even apply Lidocain, because children don't feel pain. At best, they gave muscle relaxants as chemical restraints and to make the tissue easier to cut.
watwut
I really do not understand why did you felt the need to push for circumcisions here. Like, no one asked or discussed them one way or the other. Like ok, it is religious for Jews and Arabs, but no one else have to care.
dgekfeg
[flagged]
Why is this about kids?
Do we already measure EEG for adults? Or not? If we do, why has it taken so long to do with kids? If not, is this a first step? Why start with kids rather than adults?
This article provides shockingly little context.