Isoflurane and Nerve Communication in Anesthesia

Anesthesia pic


A board-certified anesthesiologist, Dr. Brian Klagges cares for patients at Elliot Hospital in Manchester, New Hampshire. Dr. Brian Klagges also practices with Amoskeag Anesthesia, providing general as well as local and regional anesthesia.

General anesthesia is an extremely complex process. A combination of drugs renders a patient unconscious and insensible to pain, while his or her body continues to function at a basic physiological level. How this works remains largely unknown to medical science, although current research is beginning to solve a few of anesthesia’s cellular mysteries.

Researchers at Weill Cornell Medical College, for example, recently identified the key function of the commonly used inhaled anesthetic isoflurane. Building on the established knowledge that the drug interrupts cellular communication in the brain, scientists have found that this occurs due to the reduction of calcium ion flow into cells. Calcium ions allow cells to release the neurotransmitters that enable communication, the absence of which prompts the reduced consciousness and pain response in anesthetized individuals. Researcher Dr. Hugh Hemmings, Jr., and his team hope that this discovery may help developers to maximize anesthetic effectiveness and minimize side effects.


Neuromodulation – An Introduction

As director of interventional pain management and the Interventional Spine Center at Elliot Hospital, Dr. Brian Klagges performs a variety of procedures to relieve patients’ pain. In doing so, Brian Klagges, MD, draws on an in-depth knowledge of such advanced techniques as neuromodulation.

A treatment for intractable pain since the 1960s, neuromodulation uses implanted devices to manipulate nervous system activity. Many such devices are known as neurostimulators, which means that they work by altering the electrical impulses that govern the nervous system. One common such technique is spinal cord stimulation, which requires a surgeon to place an electrode in the body next to the spinal cord. This electrode generates a gentle current that blocks pain signals along the spinal cod.

Physicians may also place such electrodes along the sacral nerve, which is located in the pelvic area and responsible for many forms of pelvic pain. Intraspinal nerve root stimulation, which involves an electrode placed near the nerve root of the spine, addresses pain in the pelvic region as well as in the abdominal area. A final type, peripheral nerve stimulation, may offer relief for more distal processes.

There are also a number of neuromodulation processes that involve targeted medication delivery rather than nerve stimulation. These require the implantation of drug pumps rather than electrodes and allow for the deliver of significantly smaller doses. Such dosing may also reduce the likelihood of side effects, while potentially leading to more effective pain relief.

A Quick Look at Epidurals During Childbirth

Anesthesiologist and pain interventionalist Dr. Brian Klagges, MD, currently administers treatment to patients at Elliot Hospital in Manchester, New Hampshire. One of the procedures that pain interventionalists like Dr. Brian Klagges are licensed to perform is the epidural, which is commonly used to aid women in the process of childbirth.

An epidural is a type of regional anesthesia that temporarily blocks the activation of pain receptors within a woman’s lower spine. Though epidurals administered during birth are designed to diminish the pain associated with labor, they are not designed to completely quench feeling.

In order to administer an epidural, an anesthesiologist locates the spinal membrane and inserts a needle into the back of the woman in labor. This needle is larger than standard needles in order to allow a catheter to pass through it. Once the catheter is inserted, it is taped in place and the needle is withdrawn. Leaving the catheter in the back allows the anesthesiologist to administer additional pain medicine as needed during the delivery.

Commonly Asked Questions about Receiving Anesthesia

An MD graduate of the State University of New York at Buffalo School of Medicine and Biomedical Sciences, Dr. Brian Klagges is an anesthesiologist and pain interventionist with Amoskeag Anesthesia, PLLC. Additionally, Dr. Brian Klagges is a staff member within the Department of Surgery, Division of Anesthesiology and Pain Medicine at Elliot Hospital in Manchester, New Hampshire. The following questions are commonly posed by those who will be receiving anesthesia.

Q: Is there more than one kind of anesthesia?

A: There are several types of anesthesia, with the most common being MAC/sedation, and local, regional, and general anesthesia. The type that a patient receives for his or her surgery is based on many factors, including the kind of surgery being performed, medical history, and a surgeon’s requirements.

Q: How long will the effects of anesthesia last?

A: The length of anesthesia effects varies from a few hours to a full 24 hours. A full 24-hour resting period is recommended after undergoing anesthesia, in which professionals recommend no operation of motorized vehicles, no consumption of alcohol, and no important decision making.

Q: Can I eat or drink the night before receiving anesthesia?

A: Medical professionals ask patients not to partake in food or drinks the night before a procedure. This is because there is a possibility that a patient will vomit while under an anesthetic, and inhaling stomach contents into the lungs can cause life-threatening medical complications.

Physician Anesthesiologists Gain New Reporting Measures

With more than a decade of experience in anesthesiology and pain management, Dr. Brian Klagges currently serves as an anesthesiologist and department director at Elliot Hospital in Manchester, New Hampshire. Dr. Brian Klagges, who earned his MD from the State University of New York at Buffalo School of Medicine and Biomedical Sciences, also stays at the forefront of his field by maintaining membership with the American Society of Anesthesiologists (ASA).

In a recent press release, the ASA announced that physician anesthesiologists are now able to select from 36 reporting measures when they contribute to the ASA’s Qualified Clinical Data Registry. The ASA reported that the Centers for Medicare & Medicaid Services sanctioned 18 new Physician Quality Reporting System (PQRS) and non-PQRS measures that ASA and its partner organization the Anesthesia Quality Institute developed together.

According to ASA’s president, the new measures, which allow physician anesthesiologists to provide information on areas that are important to the practice and the patient, are especially relevant in a system shifting toward quality-based payment. Physician anesthesiologists can now report on a wide range of measures, including timely delivery of antibiotics, patient temperature management, and patient follow-up.

HydroCision’s Percutaneous HydroDiscectomy System

Dr. Brian Klagges currently serves as an anesthesiologist, pain interventionalist, and department director at Elliot Hospital in Manchester, New Hampshire. In addition to his work at the hospital, Dr. Brian Klagges was the first physician in New Hampshire to perform percutaneous hydrodiscectomy as a consultant for HydroCision, a medical device company that develops technologies like the Percutaneous HydroDiscectomy System.

Hydrodiscectomy is a minimally invasive procedure that treats leg and back pain by eliminating herniated disc tissue and releasing nerve pressure with a high-power water stream. To facilitate a safe and accurate procedure, HydroCision’s Percutaneous HydroDiscectomy System utilizes fluidjet technology to both cut and aspirate the nucleus at the same time. The high-velocity fluidjet stream cleanly removes tissue, yields no thermal damage, and reduces the possibility of annular puncture with a depth stopper and rounded tip.

For enhanced precision, the Percutaneous HydroDiscectomy System includes the carefully designed HydroDiscectomy Access Set, which ensures accurate nucleus placement. The system’s SpineJet MicroResector also works to remove consistent volumes of nucleus for predictable precision regardless of age or type.

Tufts University Sharewood Project Aids Low-Income Boston Communities