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Periodic Graphics

Periodic Graphics: The chemistry of anesthetics

Chemical educator and Compound Interest blogger Andy Brunning explores the history of anesthetics and how some of the compounds work.

by Andy Brunning, special to C&EN
October 17, 2021 | A version of this story appeared in Volume 99, Issue 38


Two-column infographic on anesthetics. The left-hand column outlines a brief history of anesthetics with relevant chemical structures. Nitrous oxide and diethyl ether were the earliest anesthetics, and the former is still in use today. Cocaine was the first local anesthetic, but lidocaine is now the most widely used. Halogenated hydrocarbons and ethers are the most commonly used inhaled anesthetics today, while propofol is the most commonly used intravenous general anesthetic.

The right-hand column of the graphic starts by highlighting the four categories of anesthesia: general (the patient is unconscious), local (a small area is numbed), regional (a larger area of the body is numbed), and sedation (the patient is drowsy and relaxed but not unconscious).

Finally, the graphic discusses how anesthetics work. Local anesthetics block sodium ion channels to halt nerve impulses; a diagram of a blocked ion channel is shown. General anesthetics block nerve transmission at synapses, but exactly how they do this is still not known.

Credit: Andy Brunning/Compound Interest

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References used to create this graphic:

Antkowiak, Bernd. “How Do General Anaesthetics Work?” Naturwissenschaften (2001). DOI: 10.1007/s001140100230.

Bezerra, Marco M., Raquel A. C. Leão, Leandro S. M. Miranda, and Rodrigo O. M. A. de Souza. “A Brief History behind the Most Used Local Anesthetics.” Tetrahedron (2020). DOI: 10.1016/j.tet.2020.131628.

Maher, Timothy J. “Anesthetic Agents: General and Local Anesthetics.” In Foye’s Principles of Medicinal Chemistry. 7th ed. Edited by Thomas L. Lemke, David A. Williams, Victoria F. Roche, and S. William Zito, 508–39. Baltimore: Lippincott Williams & Wilkins, 2013.

Perkins, Bill. “How Does Anesthesia Work?” Scientific American, Feb. 7, 2005.

Royal College of Anaesthetists. “Anaesthesia Explained.” March 1, 2021.

Royal College of Anaesthetists. “The History of Anaesthesia.” Accessed Oct. 11, 2021.

A collaboration between C&EN and Andy Brunning, author of the popular graphics blog Compound Interest

To see more of Brunning’s work, go to To see all of C&EN’s Periodic Graphics, visit



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