9780521518222

Hypnosis, amnesia, and immobility are three major therapeutic endpoints of general anesthesia. In one to two cases out of a thousand, only immobility is achieved - leaving a patient paralyzed but capable of experiencing and remembering intraoperative events. Awareness during general anesthesia is one of the most dreaded complications of surgery and is feared by patients and clinicians alike. Despite many advances in the field, there are also a number of unresolved questions that persist. Some of the difficulties in the detection and prevention of awareness during anesthesia relate to the underlying complexities of the neuroscientific basis of consciousness. Consciousness, Awareness, and Anesthesia is a multidisciplinary approach to both the scientific problem of consciousness and the clinical problem of awareness during general anesthesia. An international cadre of authors with expertise in anesthesiology, neurobiology, and philosophy provides a cutting-edge perspective. No other book on the subject has drawn from such a breadth of scholarship.

Dr. George A. Mashour received his MD and PhD in neuroscience from Georgetown University and was awarded Fulbright scholarships for neuroscience research in Berlin and Bonn. He completed his residency and chief residency in anesthesiology at the Massachusetts General Hospital and Harvard Medical School, as well as fellowship training in neuroanesthesiology at the University of Michigan. He is currently the director of neuroanesthesiology, as well as an assistant professor of anesthesiology and neurosurgery, at the University of Michigan Medical School. His main clinical interests are neuroanesthesiology and neurocritical care. Dr. Mashour's major scholarly focus is consciousness and anesthesia. He is credited with developing the cognitive unbinding paradigm of general anesthesia and advocating for the role of anesthesiology in the study of consciousness. In his clinical research, Dr. Mashour is the principal investigator of a 30,000-patient study focused on the prevention of awareness during general anesthesia. He has published and lectured extensively on the subjects of consciousness and intraoperative awareness. Dr. Mashour is the recipient of numerous awards for his work as a clinician, scholar, and educator.

Contributors	p. vii
Preface: Consciousness, awareness, and anesthesia	p. ix
Relevance of sleep neurobiology for cognitive neuroscience and anesthesiology	p. 1
The neurobiology of consciousness	p. 24
Memory formation during general anesthesia	p. 47
Dreaming during anesthesia	p. 74
Etiology and risk factors of intraoperative awareness	p. 90
Monitoring anesthetic depth	p. 114
Current controversies in intraoperative awareness: I	p. 131
Current controversies in intraoperative awareness: II	p. 148
Awareness during general anesthesia in the pediatric population	p. 172
Psychological consequences of intraoperative awareness	p. 188
Medicolegal consequences of intraoperative awareness	p. 204
Complaints of awareness after sedation and regional anesthesia: The role of patient expectations	p. 221
Philosophical implications of awareness during general anesthesia	p. 233
Index	p. 253
Table of Contents provided by Ingram. All Rights Reserved.

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Consciousness, Awareness, and Anesthesia

Consciousness, Awareness, and Anesthesia

0521518229

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