Education  |   June 2019
Understanding the Effects of General Anesthetics on Cortical Network Activity Using Ex Vivo Preparations
Author Notes
  • From the Department of Anaesthesia, Waikato District Health Board, Hamilton, New Zealand (L.J.V.); the Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia (P.S.G); Anesthesiology and Research Divisions, Atlanta Veterans Administration Medical Center, Atlanta, Georgia (P.S.G.); the Experimental Anesthesiology Section, Department of Anesthesiology, University Hospital of Tübingen, Tübingen, Germany (H.H.); and the Department of Anesthesiology, University of Wisconsin, Madison, Wisconsin (M.I.B.).
  • This article is featured in “This Month in Anesthesiology,” page 1A.
    This article is featured in “This Month in Anesthesiology,” page 1A.×
  • This article has a video abstract.
    This article has a video abstract.×
  • Submitted for publication March 3, 2018. Accepted for publication November 8, 2018.
    Submitted for publication March 3, 2018. Accepted for publication November 8, 2018.×
  • Address correspondence to Dr. García: Department of Anesthesiology, Columbia University Medical Center New York Presbyterian Hospital - Irving, 622 W 168th Street, New York, New York 10032. pg2618@cumc.columbia.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Education / Review Article / Central and Peripheral Nervous Systems / Pharmacology
Education   |   June 2019
Understanding the Effects of General Anesthetics on Cortical Network Activity Using Ex Vivo Preparations
Anesthesiology 6 2019, Vol.130, 1049-1063. doi:10.1097/ALN.0000000000002554
Anesthesiology 6 2019, Vol.130, 1049-1063. doi:10.1097/ALN.0000000000002554
Abstract

General anesthetics have been used to ablate consciousness during surgery for more than 150 yr. Despite significant advances in our understanding of their molecular-level pharmacologic effects, comparatively little is known about how anesthetics alter brain dynamics to cause unconsciousness. Consequently, while anesthesia practice is now routine and safe, there are many vagaries that remain unexplained. In this paper, the authors review the evidence that cortical network activity is particularly sensitive to general anesthetics, and suggest that disruption to communication in, and/or among, cortical brain regions is a common mechanism of anesthesia that ultimately produces loss of consciousness. The authors review data from acute brain slices and organotypic cultures showing that anesthetics with differing molecular mechanisms of action share in common the ability to impair neurophysiologic communication. While many questions remain, together, ex vivo and in vivo investigations suggest that a unified understanding of both clinical anesthesia and the neural basis of consciousness is attainable.