We’ve Been Putting People to Sleep for 175 Years. And We Still Don’t Fully Know How
A Commentary on the Mechanistic Gap in General Anesthesia
DOI:
https://doi.org/10.18192/osurj.v5i1.8083Abstract
One would think that with all the advances in modern medicine, most of the body’s functions would be at least somewhat understood. However, a very common activity in modern medicine, and medicine in general, is putting a patient to sleep with drugs or gases in order to perform surgery on an unconscious patient. In order to perform surgical procedures, a patient is usually placed on a surgical table, given a number of medications, and then made fully unconscious prior to any incisions. Once the procedure is completed, the patient is then awakened from the anesthetic and is often unable to recall anything prior to falling asleep. He or she will have no memory of the actual surgery.
Most patients do very well under general anesthesia and have few problems. However, surprisingly, little is known about the basic neurobiology of general anesthesia, and anesthesiologists are generally unable to describe in general terms how a commonly used anesthetic causes unconsciousness. The paper examines the history of the gap between promised pain relief and achieved pain relief, discusses current explanations of this, and explains why the deepest problem is not pharmacological but one of the oldest problems in science: what do we mean by ‘consciousness’ ?
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