General anesthesia has long been perceived as the same for all patients. However, new research shows that men and women may respond differently to it—a fact that has not yet been taken into account in medical practice.
As reported by Live Science, Dr. Elisha Peterson of George Washington University explains: Currently, anesthesia doses are not adjusted for gender. Historically, clinical trials have been conducted mostly on white men, so there is not enough data on women.
Currently, doctors rely on monitoring brain activity during surgery to quickly change dosages and reduce risks, including awareness during anesthesia — when a patient is partially conscious, although not feeling pain.
Previous studies have shown some interesting trends. For example, the British Journal of Anaesthesia found that women wake up more quickly after using propofol than men. And a 2023 review of more than 30 studies found that women are 38% more likely to become conscious during anesthesia.
At the same time, a 2002 study from Thailand found no serious gender differences — cases of awareness were mainly explained by insufficient depth of anesthesia.
The biological mechanisms of the difference are only beginning to be revealed. Scientists associate them with the effects of hormones — estrogen and testosterone — on brain centers, in particular the hypothalamus, as well as with the peculiarities of dopamine systems that control wakefulness.
However, despite the growing body of evidence, changing anesthetic dosing approaches based on gender is not yet recommended. As Dr. Peterson explains, this can lead to dangerous complications, such as a sharp drop in blood pressure.
For now, the safer approach remains the use of brain activity monitors and consideration of individual factors, such as alcohol consumption, which may affect sensitivity to anesthesia.
Although science is only beginning to uncover the profound differences between the sexes in response to anesthesia, it is clear that medical protocols may change in the future — and patients will receive an even more personalized approach to treatment.
