Issue Date: January 7, 2008
Groping Your Way Out Of An Anesthetic Fog
One popular hypothesis holds that a patient emerges from an anesthetized state simply because the anesthetic drug is eliminated from the neurological site of action. But new evidence indicates that patient recovery is more complicated than a mere reversal of anesthetic-induced unconsciousness. Max B. Kelz of the University of Pennsylvania and colleagues have determined that emerging from general anesthesia depends on neuropeptides named orexins (Proc. Natl. Acad. Sci. USA, DOI: 10.1073/pnas.0707146105). Produced by neurons in the brain, these compounds play a key role in promoting and maintaining normal wakefulness. The researchers also determined that inhibiting orexins had no effect on initiating anesthesia. The findings indicate that "the neural substrates governing transitions into and out of the anesthetized state need not be identical," they write. "Other currently unrecognized neuronal groups may play a critical role in mediating behavioral state transitions like general anesthesia or sleep in which consciousness is transiently yet reversibly impaired."
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