General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis
Open Access
- 21 July 2011
- journal article
- review article
- Published by Annual Reviews in Annual Review of Neuroscience
- Vol. 34 (1), 601-628
- https://doi.org/10.1146/annurev-neuro-060909-153200
Abstract
Placing a patient in a state of general anesthesia is crucial for safely and humanely performing most surgical and many nonsurgical procedures. How anesthetic drugs create the state of general anesthesia is considered a major mystery of modern medicine. Unconsciousness, induced by altered arousal and/or cognition, is perhaps the most fascinating behavioral state of general anesthesia. We perform a systems neuroscience analysis of the altered arousal states induced by five classes of intravenous anesthetics by relating their behavioral and physiological features to the molecular targets and neural circuits at which these drugs are purported to act. The altered states of arousal are sedation-unconsciousness, sedation-analgesia, dissociative anesthesia, pharmacologic non-REM sleep, and neuroleptic anesthesia. Each altered arousal state results from the anesthetic drugs acting at multiple targets in the central nervous system. Our analysis shows that general anesthesia is less mysterious than currently believed.This publication has 172 references indexed in Scilit:
- General Anesthesia, Sleep, and ComaThe New England Journal of Medicine, 2010
- Stable and dynamic cortical electrophysiology of induction and emergence with propofol anesthesiaProceedings of the National Academy of Sciences of the United States of America, 2010
- mTOR-Dependent Synapse Formation Underlies the Rapid Antidepressant Effects of NMDA AntagonistsScience, 2010
- Breakdown in cortical effective connectivity during midazolam-induced loss of consciousnessProceedings of the National Academy of Sciences of the United States of America, 2010
- Neuropathic Pain: A Maladaptive Response of the Nervous System to DamageAnnual Review of Neuroscience, 2009
- Simultaneous Electroencephalography and Functional Magnetic Resonance Imaging of General AnesthesiaAnnals of the New York Academy of Sciences, 2009
- Consciousness and AnesthesiaScience, 2008
- Type and Severity of Cognitive Decline in Older Adults after Noncardiac SurgeryAnesthesiology, 2008
- The circadian clock stops ticking during deep hibernation in the European hamsterProceedings of the National Academy of Sciences of the United States of America, 2007
- CRITICAL PERIOD REGULATIONAnnual Review of Neuroscience, 2004