For Some, Anesthesia Seems to Pose a Hidden Danger

The operating room may be one of medicine's most controlled environments, but the Atlantic reports on a group of families discovering just how little doctors understand about one of its core tools: anesthesia. Sarah Zhang traces the deaths and catastrophic brain injuries of otherwise healthy children and teens after routine procedures involving the widely used anesthetic gas sevoflurane. Their similar symptoms, brain lesions, and prolonged, disordered awakenings eventually point to an unlikely culprit: a rare, inherited variant in mitochondrial DNA that may make some patients unusually vulnerable.

The story details how a Venezuelan doctor—a mother whose young son survived a near-fatal anesthesia incident—began piecing together a case from scattered tragedies in Germany, Venezuela, Texas, Chile, and beyond, helping scientists link a rare mitochondrial mutation associated with patients of Venezuelan ancestry to sevoflurane's still-murky effects on the brain. The preliminary findings are prompting anesthesiologists to reconsider anesthesia-related risks and confront how anesthesia actually works. "How is it that anesthesiologists can induce a state that some have called 'functionally equivalent to brainstem death'—only to reverse it?" writes Zhang. "This process happens 60,000 times a day in operating rooms across the United States. Yet it remains poorly understood." Read it in full here.