General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis
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 an...
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Annual Reviews
2014
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| Online Access: | http://hdl.handle.net/1721.1/86331 https://orcid.org/0000-0001-5651-5060 https://orcid.org/0000-0003-2668-7819 https://orcid.org/0000-0001-7734-6008 |
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| author | Brown, Emery N. Purdon, Patrick Lee Van Dort, Christa |
| author2 | Harvard University--MIT Division of Health Sciences and Technology |
| author_facet | Harvard University--MIT Division of Health Sciences and Technology Brown, Emery N. Purdon, Patrick Lee Van Dort, Christa |
| author_sort | Brown, Emery N. |
| collection | MIT |
| description | 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. |
| first_indexed | 2024-09-23T16:22:21Z |
| format | Article |
| id | mit-1721.1/86331 |
| institution | Massachusetts Institute of Technology |
| language | en_US |
| last_indexed | 2024-09-23T16:22:21Z |
| publishDate | 2014 |
| publisher | Annual Reviews |
| record_format | dspace |
| spelling | mit-1721.1/863312022-10-02T07:49:47Z General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis Brown, Emery N. Purdon, Patrick Lee Van Dort, Christa Harvard University--MIT Division of Health Sciences and Technology Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences Brown, Emery N. Purdon, Patrick Lee Van Dort, Christa 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. Massachusetts General Hospital. Dept. of Anesthesia and Critical Care National Institutes of Health (U.S.) (Director's Pioneer Award DP10D003646) National Institutes of Health (U.S.) (New Innovator Award DP2OD006454) National Institutes of Health (U.S.) (Grant K25-NS057580) National Institutes of Health (U.S.) (Training Program in Sleep, Circadian and Respiratory Neurobiology HL07901) 2014-05-01T16:44:35Z 2014-05-01T16:44:35Z 2011-07 Article http://purl.org/eprint/type/JournalArticle 0147-006X 1545-4126 http://hdl.handle.net/1721.1/86331 Brown, Emery N., Patrick L. Purdon, and Christa J. Van Dort. “General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis.” Annual Review of Neuroscience 34, no. 1 (July 21, 2011): 601–628. https://orcid.org/0000-0001-5651-5060 https://orcid.org/0000-0003-2668-7819 https://orcid.org/0000-0001-7734-6008 en_US http://dx.doi.org/10.1146/annurev-neuro-060909-153200 Annual Review of Neuroscience Creative Commons Attribution-Noncommercial-Share Alike http://creativecommons.org/licenses/by-nc-sa/4.0/ application/pdf Annual Reviews PMC |
| spellingShingle | Brown, Emery N. Purdon, Patrick Lee Van Dort, Christa General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis |
| title | General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis |
| title_full | General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis |
| title_fullStr | General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis |
| title_full_unstemmed | General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis |
| title_short | General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis |
| title_sort | general anesthesia and altered states of arousal a systems neuroscience analysis |
| url | http://hdl.handle.net/1721.1/86331 https://orcid.org/0000-0001-5651-5060 https://orcid.org/0000-0003-2668-7819 https://orcid.org/0000-0001-7734-6008 |
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