Redheads Are a Tough Knockout in Surgery

[Guest guest]

Redheads Are a Tough Knockout in Surgery

By Holly VanScoy

HealthScoutNews Reporter

From HealthScoutNews

Oct. 16 - If you're a natural redhead facing surgery, you may want to

have a chat with your anesthesiologist before heading for the operating

room.

A new study finds you're likely to need more anesthesia when you

go under the knife than do people with other hair colors. Researchers at

the University of Louisville discovered that, on average, people born

with red hair require about 20 percent more anesthesia to obtain

satisfactory sedation.

Dr. Edwin B. Liem, an anesthesiologist at Louisville's Outcomes

Research Institute and the study's principal investigator, presented his

results today at the American Society of Anesthesiologists annual

meeting in Orlando, Fla.

Red hair, he discovered, may be a small detail that makes a big

difference in terms of memory, pain and sedation in the operating room.

" A person who receives too little anesthesia may recall the

surgery or may have actually have heightened pain during the procedure, "

Liem explains. " Neither of these are desirable outcomes. The art and

science of anesthesiology is determining just the right amount of

anesthesia to achieve unconsciousness, pain tolerance and suppression of

memory without causing adverse consequences, such as cardiac or

pulmonary complications. Red hair is apparently an important element in

this decision. "

According to Liem, the discovery is particularly noteworthy

because red hair is the first visible human characteristic - or

phenotype - to be linked to the amount of anesthetic needed in surgery.

Although neither he nor anyone else knows exactly why this link exists,

Liem says his best guess at the moment is that it's somehow related to

what's known as the " dysfunctional melanocortin 1 receptor. "

Scientists have known for a long time that melanocortin receptors

on certain cells are responsible for hair and skin color. Liem believes

a dysfunction of this receptor triggers an increase of the hormone that

usually stimulates the cells. This happens to be the very same hormone

that stimulates a receptor in the brain that governs pain sensitivity.

" Redheads are likely to experience more pain from most stimuli -

surgery is just one example - and therefore require more anesthesia to

alleviate that pain, " Liem says.

Redheadedness has been linked to other medical anomalies or

differences in the past.

Dr. Larrian Gillespie, a urologist and gynecologist in Beverly

Hills, Calif., says there are a number of " redhead-related " disorders,

as these are increasingly called.

In treating interstitial cystitis, for example, Gillespie has

found black women are unlikely to have the condition - unless they have

a naturally redheaded mother or grandmother.

" There are definitely different metabolic factors at work in

redheads, " she says. " I am not at all surprised to learn that redheads

need more anesthesia than non-redheads. The red hair is more than a

cosmetic characteristic; it is a biological marker, apparently for many

other bodily processes. "

Previous research has shown that redheads tend to have skin that

is more sensitive to the sun and may have as much as five times the risk

of melanoma, a skin cancer. And 2000 study suggested red hair may

accumulate drugs at a different rate than hair of other colors, thus

letting redheads pass drug tests more easily than brunettes.

The fact that they're not exactly like everyone else can have

important implications for redheads, says Liem - especially redheads

facing surgery.

" If I had red hair, I'd want to make sure my anesthesiologist is

familiar with the fact that I'm very likely to need more anesthesia

because of my hair color, " he says. " Many anesthesiologists have already

figured this out in practice and will give more anesthesia, but for

those anesthesiologists that aren't aware, it would be a good idea to

point this out. "

Of equal importance, Liem notes, is that the research provides

some of the strongest evidence to date that genetics plays a role in

anesthetic requirements in humans.

" Despite more than a century of research and the fact that

anesthesia is extraordinarily safe, we still are not at all certain

about how anesthetic gases work, " he admits. " Unraveling the link

between red hair, the mutations at the melanocortin 1 receptor, and

anesthetic requirements may be a first step toward understanding how

inhalational anesthetics work. "

What To Do

Redheaded or not, if you're facing surgery, it's good to know how

anesthesia works and what to expect. For information, check out

Anesthesia.net. If you're interested in the world of redheads, try Red

and Proud.