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Previous Volume 348:2110-2124 May 22, 2003 Number 21 Next

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"Suffering so great as I underwent cannot be expressed in words . . . but the blank whirlwind of emotion, the horror of great darkness, and the sense of desertion by God and man, which swept through my mind, and overwhelmed my heart, I can never forget."¹ Such was the experience of surgery before October 1846, when William Morton's successful public demonstration of ether anesthesia at Massachusetts General Hospital led to its widespread acceptance by surgeons. Today, anesthesiologists employ a wide variety of drugs, some of which they use exclusively to produce general anesthesia.^2,3 This review focuses on the inhaled . . . [Full Text of this Article]

The Changing Use and Role of General Anesthesia

What is General Anesthesia?

Nonspecific Pharmacology and Lipid Theories of Anesthetic Action

Behavioral Pharmacology of Inhaled Anesthetic Actions

Anesthetic Actions on Different Regions of the Nervous System

The Spinal Cord

The Brain

Molecular Actions of Inhaled Anesthetics

Protein Sites

Effects of Anesthetics on Ion Channels

GABA_A Receptors

Other Ion Channels

Anesthetic Sites on Ion-Channel Proteins

Integrated Models of the Mechanisms of Anesthesia

Synaptic Mechanisms

In Vivo and In Vitro Neural Networks

Genetic Studies of Inhaled Anesthetic Actions

Genetic Screening

Studies in Genetically Modified Mammals

            Knockout Studies

            "Knock-In" Studies

Summary

Source Information

From the Department of Anesthesia and Critical Care, Massachusetts General Hospital (J.A.C., K.W.M., S.A.F.), and the Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School (K.W.M.) — both in Boston.

Address reprint requests to Dr. Forman at the Department of Anesthesia and Critical Care, CLN-3, Massachusetts General Hospital, 10 Fruit St., Boston, MA 02114, or at saforman@partners.org.

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