anesthesia

I developed a special interest for anesthesia.
I find it abnormally superb that the possibility of ‘shutting down’ somebody and ressuscitating him exist.

Anesthesia is not about putting someone to sleep – It is about waking him up.

Anesthesia is a drug-induced, reversible coma based on 3 principles:

1. Amnesia (memory and unconsciounsness) - You won’t remember anything. Your brain doesn’t form memories, and you’re not aware of what’s going on.
2. Akinesia (muscle paralizis) - You can’t move. The muscles are paralyzed, keeping your body still during procedures.
3. Analgesia (pain relief) - You don’t feel pain. The entire process is pain-free, even if your body is going through something invasive.

Common anesthetics include drugs like propofol (often used to induce and maintain general anesthesia), sevoflurane (a gas anesthetic for maintaining unconsciousness), and ketamine (which induces a dissociative state, often used in both general and local anesthesia).

• Propofol is an intravenous sedative-hypnotic agent that works by enhancing GABA activity in the brain, leading to rapid sedation and anesthesia. It’s widely used for both induction and maintenance of general anesthesia due to its smooth recovery and controllability.

• Sevoflurane is an inhaled anesthetic that works by affecting ion channels in the brain to induce anesthesia. It’s well-tolerated but can cause airway irritation and respiratory depression.

• Ketamine is a dissociative anesthetic that blocks NMDA receptors, leading to pain relief, sedation, and dissociation (a sense of detachment from the body). Unlike propofol or sevoflurane, it can cause hallucinations and increased blood pressure.

For muscle relaxation, drugs like rocuronium and succinylcholine are frequently used to paralyze the muscles temporarily.

• Succinylcholine is a depolarizing neuromuscular blocker. It works by mimicking acetylcholine, a neurotransmitter that normally activates muscle contraction.

• Rocuronium is a non-depolarizing neuromuscular blocker. It works by competing with acetylcholine for binding to nicotinic receptors on the muscle cell surface. Unlike succinylcholine, rocuronium does not cause depolarization or muscle contraction. Instead, it blocks the receptor, preventing acetylcholine from binding and, therefore, stopping muscle contraction.

Opiods are often used to manage pain during and after procedures. They are powerful pain-relieving medications that work by binding to opioid receptors in the brain and spinal cord to block pain signals.

• Morphine is a naturally occurring opioid derived from the opium poppy, and it’s widely used for managing moderate to severe pain, particularly after surgeries or in cases of injury.

• Fentanyl is a synthetic opioid that is much stronger than morphine—about 50 to 100 times more potent¹. It is used for severe pain management, often in patients undergoing surgery or those with chronic pain, such as in cancer treatment.

On the other hand, medication like valium (diazepam) and midazolam are benzodiazepines that are often given to relax patients and reduce anxiety before anesthesia is induced.

What fascinates me even more is that despite how commonly anesthesia is used, especially in surgeries or dental work, we still don’t fully understand how some of these drugs work. Take propofol, for example, a widely used anesthetic. While we know it puts you under, the exact biochemical mechanism of action is poorly understood. For a drug that’s been in use for decades, it’s surprising that so much is still unknown.

For me, anesthesia is the perfect intersection of science, trust, and human ingenuity. It’s an art form wrapped in an enigma, and that’s what makes it so endlessly fascinating.