title: Impact of right-handedness on anaesthetic sensitivity, intra-operative awareness and postoperative mortality.
abstract: Anatomical, neurological and behavioural research has suggested differences between the brains of right- and non-right-handed individuals, including differences in brain structure, electroencephalogram patterns, explicit memory and sleep architecture. Some studies have also found decreased longevity in left-handed individuals. We therefore aimed to determine whether handedness independently affects the relationship between volatile anaesthetic concentration and the bispectral index, the incidence of definite or possible intra-operative awareness with explicit recall, or postoperative mortality. We studied 5585 patients in this secondary analysis of data collected in a multicentre clinical trial. There were 4992 (89.4%) right-handed and 593 (10.6%) non-right-handed patients. Handedness was not associated with (a) an alteration in anaesthetic sensitivity in terms of the relationship between the bispectral index and volatile anaesthetic concentration (estimated effect on the regression relationship -0.52 parallel shift; 95% CI -1.27 to 0.23, p = 0.17); (b) the incidence of intra-operative awareness with 26/4992 (0.52%) right-handed vs 1/593 (0.17%) non-right-handed (difference = 0.35%; 95% CI -0.45 to 0.63%; p = 0.35); or (c) postoperative mortality rates (90-day relative risk for non-right-handedness 1.19, 95% CI 0.76-1.86; p = 0.45). Thus, no change in anaesthetic management is indicated for non-right-handed patients.
authors.affiliation: Washington University School of Medicine, Saint Louis, Missouri, USA.
authors.forename: S
authors.initials: S
authors.lastname: Rao
authors.forename: A R
authors.initials: AR
authors.lastname: Huverserian
authors.forename: A
authors.initials: A
authors.lastname: Ben Abdallah
authors.forename: K
authors.initials: K
authors.lastname: Lees
authors.forename: M D
authors.initials: MD
authors.lastname: Willingham
authors.forename: B A
authors.initials: BA
authors.lastname: Burnside
authors.forename: A J
authors.initials: AJ
authors.lastname: Villafranca
authors.forename: D B
authors.initials: DB
authors.lastname: Glick
authors.forename: E
authors.initials: E
authors.lastname: Jacobsohn
authors.forename: M S
authors.initials: MS
authors.lastname: Avidan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000777:Anesthetics / Q000494:pharmacology*; D004569:Electroencephalography; D005260:Female; D007839:Functional Laterality; D006801:Humans; D058926:Intraoperative Awareness; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011184:Postoperative Period
chemical_list: D000777:Anesthetics