The Neurobiology of Anesthetic Emergence.
Achieving a smooth and rapid emergence from general anesthesia is of particular importance for neurosurgical patients and is a clinical goal for neuroanesthesiologists. Recent data suggest that the process of emergence is not simply the mirror image of induction, but rather controlled by distinct neural circuits. In this narrative review, we discuss (1) hysteresis, (2) the concept of neural inertia, (3) the asymmetry between the neurobiology of induction and emergence, and (4) recent attempts at actively inducing emergence.
Department of Anesthesiology, Division of Neuroanesthesiology, Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI.
Vijay
V
Tarnal
Phillip E
PE
Vlisides
George A
GA
Mashour
D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D006801:Humans; D009446:Neurobiology; D009474:Neurons / Q000187:drug effects*; D019635:Neurosurgical Procedures