Our Summary

This research paper examines the relationship between anesthesia and brain cell death (neuroapoptosis) in unborn lambs (fetuses). Previous studies suggested that anesthesia could cause brain cell death in young animals, but these studies didn’t involve surgery. In this study, the researchers explored whether performing surgery on the fetus could reduce the brain cell death caused by anesthesia.

The researchers exposed pregnant ewes (female sheep) at 70 days of gestation to either a low dose of 2% isoflurane (a type of anesthesia) for 1 hour, or a high dose of 4% isoflurane for 3 hours. Some of these ewes had surgery performed on their fetuses, while others did not. The researchers then compared the rates of brain cell death in the fetuses.

They found that the fetuses that had undergone surgery had lower rates of brain cell death in two areas of the brain (the dentate gyrus and the pyramidal layer of the hippocampus) compared to those that had not had surgery. This was particularly true for those exposed to the high dose of anesthesia. However, surgery did not affect brain cell death in the frontal cortex or endplate of the fetuses.

In other words, the study suggests that performing surgery on a fetus could potentially reduce the harm caused by anesthesia to the brain. However, more research is needed to understand the long-term impacts of these findings on memory and learning.

FAQs

  1. Does anesthesia cause brain cell death in unborn lambs?
  2. Can performing surgery on a fetus reduce the brain cell death caused by anesthesia?
  3. What are the possible long-term impacts of these findings on memory and learning?

Doctor’s Tip

A helpful tip a doctor might give a patient about brain surgery is to follow all pre-operative instructions carefully, such as fasting before surgery and avoiding certain medications. It is also important to communicate any concerns or questions with your healthcare team before the procedure. After surgery, it is crucial to follow post-operative care instructions, attend follow-up appointments, and report any unusual symptoms or changes in your condition to your healthcare provider. Recovery from brain surgery can be a slow process, so it is important to be patient and allow yourself time to heal properly.

Suitable For

Patients who are typically recommended brain surgery include those with:

  1. Brain tumors: Surgery is often recommended to remove tumors that are causing symptoms or are suspected to be cancerous.

  2. Epilepsy: Surgery may be considered for patients whose seizures are not controlled with medication and are localized to a specific area of the brain.

  3. Traumatic brain injury: Surgery may be needed to repair damage to the brain caused by a head injury.

  4. Vascular malformations: Surgery may be recommended to repair abnormal blood vessels in the brain that are at risk of bleeding.

  5. Hydrocephalus: Surgery may be necessary to place a shunt to drain excess cerebrospinal fluid from the brain.

  6. Parkinson’s disease: Deep brain stimulation surgery may be recommended for patients with severe symptoms that are not controlled with medication.

  7. Chiari malformation: Surgery may be required to decompress the brainstem and spinal cord in patients with this structural abnormality.

  8. Brain abscess or infection: Surgery may be necessary to drain pus or remove infected tissue from the brain.

It is important for patients to discuss the risks and benefits of brain surgery with their healthcare provider to determine the best course of treatment for their specific condition.

Timeline

Before brain surgery:

  1. Patient is diagnosed with a condition that requires brain surgery, such as a tumor, aneurysm, or epilepsy.
  2. Patient undergoes pre-operative assessments, including imaging scans, blood tests, and consultations with the surgical team.
  3. Patient may need to stop certain medications or make lifestyle changes in preparation for surgery.
  4. Patient receives anesthesia before the surgery begins.

During brain surgery:

  1. Surgeon makes an incision in the scalp and removes a portion of the skull to access the brain.
  2. Surgeon performs the necessary procedure, such as tumor removal, blood vessel repair, or seizure focus resection.
  3. Anesthesia is closely monitored throughout the surgery to ensure the patient remains unconscious and pain-free.
  4. Surgery can last several hours, depending on the complexity of the procedure.

After brain surgery:

  1. Patient is taken to the recovery room to wake up from anesthesia and be monitored for any immediate complications.
  2. Patient may experience side effects such as headaches, nausea, or confusion in the days following surgery.
  3. Patient is gradually weaned off pain medications and may begin physical or occupational therapy to aid in recovery.
  4. Patient attends follow-up appointments with the surgical team to assess healing and discuss any ongoing symptoms or concerns.
  5. Patient may need ongoing rehabilitation or medication management to support brain function and recovery.

What to Ask Your Doctor

  1. What specific type of brain surgery will I be undergoing and what are the potential risks and benefits associated with it?
  2. How will anesthesia be administered during the surgery and what are the potential effects on brain cell death?
  3. Are there any alternative treatment options to brain surgery that I should consider?
  4. What is the expected recovery time following the surgery and what post-operative care will be needed?
  5. What are the potential long-term impacts on memory and learning from undergoing brain surgery with anesthesia?
  6. Will I need any additional follow-up appointments or tests after the surgery to monitor my brain health?
  7. How experienced is the surgical team in performing this specific type of brain surgery?
  8. Are there any specific lifestyle changes or precautions I should take after the surgery to promote brain health and healing?
  9. What is the success rate of this type of brain surgery and what is the likelihood of any complications occurring?
  10. Are there any support resources or counseling services available to help me cope with the emotional and psychological aspects of undergoing brain surgery?

Reference

Authors: Olutoye OA, Cruz SM, Akinkuotu AC, Sheikh F, Zamora IJ, Yu L, Adesina AM, Olutoye OO. Journal: Fetal Diagn Ther. 2019;46(2):111-118. doi: 10.1159/000491925. Epub 2018 Oct 12. PMID: 30317244