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- W2055938002 abstract "I read with interest the recent editorial by Young and Matta (Young & Matta. Anaesthesia 2000; 55: 105–6). I was left in a state of confusion and perplexity. The authors state that it is essential that public confidence be maintained in the transplant programme. It seems to me that encouraging the use of volatiles and opioids to provide ‘anaesthesia’ implies that these substances are required to prevent awareness of an unpleasant stimulus. This kind of muddled thinking will not reassure the general public but will, instead, confuse the issue further. The recommendation of the Intensive Care Society is admirably clear in its distinction between conscious awareness and reflex response. It is also worthy of note that for the diagnosis of brain death to be made, all sedatives must be stopped to ensure that their effects are not mimicking some of the effects of brain death. It seems to me illogical that a patient can be taken off all sedatives to make a diagnosis of brain death only for them to be restarted once the diagnosis has been made. The issue of staff disquiet is a well-made point but reflects rather a lack of education and support rather than a reason for administering anaesthesia. The fact that such questions still arise amongst members of the medical profession also raises the question as to the validity of the current brain stem tests as the standard required prior to organ donation. It is vital that we, as a profession, agree what the responses to surgery in organ donors mean. If this requires further investigation, e.g. EEG monitoring, then this should be performed as a matter of urgency. If it is felt that cerebral activity is irrelevant, then, in the presence of brain stem death, talk of ‘general anaesthesia’ should be avoided as it is misleading and potentially upsetting." @default.
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- W2055938002 date "2000-07-01" @default.
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- W2055938002 title "The implications of anaesthetising the brainstem dead: 2" @default.
- W2055938002 doi "https://doi.org/10.1046/j.1365-2044.2000.01557-2.x" @default.
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