The Anesthesia Blog has tended to attract a certain tech-geek type of anesthesia provider. We have attempted to cater to our audience by highlighting anesthesia tech products, smartphone apps and advances in our field. Like many who sit and ponder about all things anesthesia, we’ve often wondered how anesthesia actually produces its desired effect? Meyer-Overton was a nice thought but proven too simplistic. Last we heard it had something to do with meddling with the lipid bilayer sandwich…but nobody seems to know for sure.
In a provocatively titled article in Scientific American called “What Doctors Don’t Understand About Anesthesia” we dive deeper into an interesting revelation into the effects of anesthesia on the brain:
Highlighting these fundamental gaps in knowledge, a group of researchers recently made a surprising discovery about how we transition out of consciousness and back. The common view holds that going under (induction) and coming back up (emergence) are the same process, albeit in different directions. However, a recent study published in the journal PLoS ONE suggests that going under is not the same as coming back up.
The researchers, led by Dr. Max Kelz at the University of Pennsylvania School of Medicine, observed that less anesthetic is required to keep the brain anesthetized than to induce unconsciousness. To explain these observations, the researchers have introduced a concept they call “neural inertia,” referring to the brain’s resistance to transitions between consciousness and unconsciousness. Elucidating the mechanisms of neural inertia could be critical to the task anesthesiologists perform every day, namely preventing patients from experiencing pain or awareness during surgery and in helping those patients who exhibit delays returning to the conscious state. This line of research could also provide insights into disrupted states of consciousness like coma.
Excellent work by Dr Kelz. Thanks for adding to our understanding.