General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis
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Brown_General Anesthesia.pdf
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Author(s)
Brown, Emery N.
Purdon, Patrick Lee
Van Dort, Christa
Date Issued
July 2011
Journal
Annual Review of Neuroscience
Publisher
Annual Reviews
Citation
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.
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Author's final manuscript
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.
MIT Department
Harvard University--MIT Division of Health Sciences and Technology
Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences
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DOI of Published Version
https://doi.org/10.1146/annurev-neuro-060909-153200
