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Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Real-Time fMRI Brain Mapping in Animals
04:05

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Published on: September 24, 2020

Understanding anesthesia through functional imaging.

Ramachandran Ramani1, Richa Wardhan

  • 1Yale University School of Medicine, New Haven, Connecticut 06520-8051, USA. ramachandran.ramani@yale.edu

Current Opinion in Anaesthesiology
|September 12, 2008
PubMed
Summary
This summary is machine-generated.

Recent brain imaging studies reveal distinct patterns of regional cerebral blood flow (rCBF) changes and connectivity alterations associated with anesthesia and analgesia, offering insights into central nervous system effects.

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Published on: January 13, 2018

Area of Science:

  • Neuroscience
  • Anesthesiology
  • Pain Management

Background:

  • Anesthesia and analgesia involve complex central nervous system (CNS) effects.
  • Understanding these effects is crucial for optimizing patient care and safety.

Purpose of the Study:

  • To review recent functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and connectivity studies in anesthesia and analgesia.
  • To elucidate the neurobiological underpinnings of hypnotic and analgesic effects.

Main Methods:

  • Review of functional magnetic resonance imaging (fMRI) studies.
  • Analysis of positron emission tomography (PET) scan data.
  • Examination of brain connectivity studies.

Main Results:

  • Inhaled anesthetics (isoflurane, sevoflurane) at 0.2-1 minimum alveolar concentration (MAC) show consistent changes in regional cerebral blood flow (rCBF), with increases in the anterior cingulate cortex and insula, and decreases in the thalamus, lingual cortex, and cerebellum.
  • Lower MAC levels (0.25) predominantly decrease cortical rCBF while increasing subcortical rCBF, impacting association cortices.
  • Connectivity studies and electroencephalogram (EEG) changes (alpha to delta wave transition) correlate with hypnotic effects, suggesting thalamo-cortical pathway involvement.
  • Acute pain activates regions like the anterior cingulate cortex, S1, and S2. Remifentanil infusion modulates these activations, decreasing pain perception and increasing pain modulation.
  • Chronic pain states exhibit increased activity in the prefrontal cortex and insula, with decreased thalamic activity.

Conclusions:

  • Emerging patterns of neuronal activity are being identified that correlate with hypnosis, analgesia, amnesia, and reflex suppression.
  • These findings provide a better insight into the CNS effects of anesthesia.
  • Continued research using advanced neuroimaging techniques will further refine our understanding of anesthetic mechanisms.