Why Having An Anaesthetic Is Such A Pain

Main Category: Pain / Anesthetics
Article Date: 07 Jul 2008 - 1:00 PDT

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If you're one of the estimated hundred million people worldwide each year who needs surgery, chances are you may also need a general anaesthetic to knock you out while the operation is taking place. General anaesthetic drugs, which work by depressing the central nervous system, have transformed the world of surgery. But while they have made having operations so much safer, not to mention less painful, some general anaesthetics could make post-surgery pain worse, say experts from Georgetown University Medical Center.

Writing in the Proceedings of the National Academy of Science (i), the Georgetown neuroscientists have explained why some people feel a burning sensation when they're given an injection of a so-called 'noxious' general anaesthetic drug - and it's all to do with a nerve receptor called TRPA1, which is also called the mustard-oil receptor.

Take the TRPA1 receptor away, and the burning sensation no longer exists - at least that's what happened in tests involving mice. 'Noxious' general anaesthetics are also though to cause pain and irritation in some patients long after their anaesthetic effect has worn off, which is also caused by the TRPA1 receptor, the scientists claim.

Since controlling post-operative pain is a priority for anaesthetists, the discovery could lead to the development of anaesthetic drugs that don't involve the TRPA1 receptor. There again, anaesthetists could try learning a technique called Medical NLP.

NLP in anaesthesia

Khalid Hasan is a consultant anaesthetist at University Hospital Birmingham who uses Medical NLP on a daily basis. By using the techniques with patients before they go into surgery, he finds they require fewer anaesthetic drugs during the operation, and that they recover more quickly afterwards.

"In anaesthesia we see patients before their operation, so I started to use NLP techniques to ensure that their anxieties were managed and to control their expectations, and also to frame how they were going to feel after the operation," Explains Dr Hasan.

"When patients are very anxious before an operation, we give them a pre-med - usually a sleeping tablet or painkiller - on the ward before they come to theatre to help them cope. Then I started using NLP techniques to put them at their ease. Eventually I realised that I hadn't given any of my patients a pre-med for more than a year because they were so relaxed, they didn't need it.

"Interestingly, very occasionally I might end up anaesthetising a patient who I haven't seen on the ward - for instance, a patient one of my colleagues might have seen instead - so the first time I meet them is in the operating theatre. These patients are always much more difficult to anaesthetise and put off to sleep because their anxiety levels are not where they'd be if I'd seen them beforehand. Consequently, I have to use a lot more drugs to put them to sleep.'"

Magic in Practice

Dr Hasan was trained in Medical NLP by Garner Thomson, co-author of Magic In Practice (Hammersmith Press, £24.99). Thomson and co-author, Dr Khalid Khan - both lecturers and GP and medical student trainers - are the founders of Medical NLP, which they describe as 'the study and application of linguistic expertise in the health professions'.

Medical NLP is based on the principles of a set of techniques called Neuro-Linguistic Programming (NLP), developed by Dr Richard Bandler. Courses based on Medical NLP have already been taught to hundreds of doctors, nurses, medical students and allied health professionals from around the world.

Unique features of the book

Principles and techniques all applied in clinical conditions by specialists in several fields, including nursing, general practice, anaesthesia, gastro-intestinal medicine, orthopaedic surgery and psychology

Practical exercises, including some never published before

Extensive referencing; latest research into body-mind medicine

Interactive website through which readers can contact author and colleagues

Regular live trainings to supplement book content

About the Authors

Garner Thomson, NLP Meta-Master Practitioner and Trainer, is the developer and senior presenter of the Medical NLP Health Practitioner course, now being taught to doctors and medical students, dentists, nurses and other allied health professionals. With a background in psychology and communications he is widely regarded as one of the country's leading instructors and practitioners. He trained and works with Dr Richard Bandler, co-creator and developer of NLP and runs a busy London NLP and Hypnotherapy practice, largely by referral from GPs and consultants, conducts business trainings and consults with companies committed to the welfare of their employees and to creating a productive, healthy and creative working environment. His work has been featured in a wide range of magazines and newspapers, including The BMJ, The Times, The Guardian, Canadian Life, Management Today and in Choosing to Heal, Surviving the Breast Cancer System, by Janet Edwards. Garner Thomson has presented prime-time series for BBC Television and has consulted on a number of other productions for Channel 4 and E4. He is a regular guest on both radio and television.

Dr Khalid Khan, is a primary care physician and registered pharmacist. A GP-Trainer, writer and an undergraduate tutor for King's College London School of Medicine and St George's University of London, he also practices as a medical acupuncturist, a Fellow of the Chinese Medical Institute and Register (CMIR), and is an advisor to the International Journal of Acupuncture. A registered NLP Master Practitioner and a Medical NLP Health Practitioner, he is co-founder and primary care advisor to the Society of Medical NLP. Dr Khan is author of the popular Mnemonics for Medical Students

Magic In Practice is published by the Hammersmith Press, priced £24.99.
http://www.hammersmithpress.co.uk

(i) "General anesthetics activate a nociceptive ion channel to enhance pain and inflammation."
José A. Matta, Paul M. Cornett, Rosa L. Miyares, Ken Abe, Niaz Sahibzada, and Gerard P. Ahern.
Proceedings of the National Academy of Sciences June 24, 2008 | vol. 105 | no. 25 | 8784-8789

http://www.magicinpractice.com
http://www.medicalnlp.com