the difference between general anaesthesia, a medically indjced coma, and a coma caused by a traumatic brain injury, aside from the fact that doctors induce the first two and can easily reverse them. Is there anything different going on in your body/mind while in these States?
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The difference between and induced coma and general anesthesia is time and reason. General anasthesia is short and used to provide safety and comfort during surgery, where an induced coma is longer and used to slow the metabolism of the brain for an extended time to prevent excessive swelling that can cause more permanent damage.
A coma from injury occurss when certain parts of the brain are damaged. A person may come out of a coma if those parts can be healed, but they may still have permanent damages that last after they wake up.
I tried to ELI5, but I’m tired, so here’s my best attempt at just plain English instead:
Other people have answered other parts of this question already, so I’ll just add a little. There really isn’t much difference between a medically induced coma and general anaesthesia; the first of these isn’t actually a medically accepted term. That said, the duration of anaesthesia changes the way it’s performed.
To ‘put someone under’, called inducing anaesthesia, you have to use several drugs since no one drug will safely achieve everything you need. Commonly, this will involve one anaesthetic, one pain-killer (analgesic), and one paralytic to make it physically easier to control the patient’s airway. Combinations in use here include ketamine (both an anaesthetic and analgesic) and either suxamethonium or rocuronium, which is common outside of a hospital by an ambulance service, or propofol, fentanyl and rocuronium. American hospitals also commonly use etomidate, which is uncommon where I live because it causes adrenal insufficiency. In surgery, a much wider selection of very short-acting drugs are also commonly used, like remifentanyl, but they all do the same thing. Induction in operating theatres will also commonly included an inhaled volatile anaesthetic like isoflurane, but these usually aren’t used in emergencies for a variety of reasons.
The keep someone under, you no longer need to keep them paralysed – it’s usually safe to let that drug wear off, and let them breathe for themselves. Drugs like ketamine and paralytics tend not to be used for very long, although they sometimes can be. For maintenance, it’s pretty common to see infusions of drugs like morphine (analgesic) and midazolam (anaesthetic/sedative), fentanyl and midazolam, or some other combination which might also include propofol.
E: Oh! Thank you for the gold. That’s very cool of you.
There are different levels of sleep and unconsciousness.
If you think of the brain as an engine, and going 100% is being awake and going 0% is dead. Awake is 100%, Dreaming is 80%, really deep sleep is about 50-60 (but can get as low as 40), general anaesthesia is generally between 40-60 (so really deep asleep). A coma patient on the other hand is idling at a mere 30-40% or maybe even lower.
The difference between a coma due to injury and a medical induced coma is that there is nothing wrong with the medically induced coma patient (or rather there shouldn’t be anything wrong). As soon as you stop those drugs throttling down the brain a medical induced coma patients brain should be revving right up.
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