January 25, 2010

The Mysteries and Importance of Anesthesia

How the brain reacts to anesthesia is a neuroscientific phenomenon that includes a dash of mystery. But the study of anesthesia could lead to treatment of sleep issues frequently associated with many mental disorders.

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Transcript

Introduction: Welcome to “Speaking of Science”, the National Institute of Mental Health presents a series of conversations with innovative researchers working in a wide range of disciplines to pave the way for the prevention, recovery, and cure of mental illness.  
Narrator: The idea of having major surgery is a scary thought for most of us. But ask yourself this- what is it about the procedure that frightens you the most?

Dr. Brown: Patients will frankly tell you that they’re often more afraid of the anesthesia than they are the surgery. That’s more disquieting to them.

Narrator: Dr. Emery Brown is a professor of anesthesia at Harvard Medical School, a professor of Computational Neuroscience at MIT and a man who appreciates history.

The father of anesthesia, at least as it was known in the 19th century, was a Boston area dentist named William Morton. In 1846, at Massachusetts General Hospital, Morton was the first to publically demonstrate the use of a surgical anesthetic. At the time, surgery could be brutally painful- especially the type of battlefield procedures common during the Civil War.

Dr. Brown: It changed the practice of surgery, you know prior to that time the skill of a surgeon was measured by how quickly he can take off a limb or complete an operation. And overnight the practice of surgery was transformed from being butchery and trauma to a real humane therapy.

Narrator:  At Harvard and MIT, Dr. Brown is engaged in statistical research into how anesthetic drugs act in the human brain… or to put it another way…

Dr. Brown: When humans make the transition through different states of anesthesia, what’s happened inside of the brain?

What we don’t appreciate as anesthesiologist is how much of a neuroscience phenomenon anesthesiology really is.

Narrator:  In studying these effects on the brain there are many objectives. Among them, further development of site specific drugs that can reduce negative surgical side effects.

Dr. Brown: You know such as sort of common things like nausea, vomiting and perhaps more serious effects such as abnormal heart rhythms or delayed awakening. Those are occurring because the drugs are acting at a site where you don’t want them to act, or they are acting at the intended sites for too long a period.

Narrator:  And Dr. Brown’s research might one day assist in the treatment of sleep issues frequently associated with certain mental disorders.

Dr. Brown: So if you just ask the question what things are like anesthesia?  The first thing that comes to mind is obviously the sleep circuits. So you would think that maybe learning how to control those better would allow you to come up with more plausible ways to maybe naturally induce anesthesia. I think that’s something that a lot of people have realized. We, as an anesthesiologist, should pick liberally from the inside instead of being gained in these other areas, by the same token we’re repositories as clinical anesthesiologists who give large numbers of drugs to large numbers of people every day. Repositories have a lot of clinical experience and insights which if they were investigated to give us a lot of information about how the brain is working and also how these drugs are working.

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