Thursday, July 13, 2006

A great mystery

Anaesthetists often say, “We don’t know how these agents work”. Its not to try and make the whole thing more mysterious and keep non-initiates out –its because we truly don’t know why our anaesthetics induce unconsciousness (or Hypnosis to use the correct term). The conventional explanation is that they alter cell membrane fluidity, this being demonstrated by showing that the more fat-soluble a compound the more potent an anaesthetic it is. This also would nicely explain why molecules with no obvious similarity in structure could produce the same effect. To me this all seems a little vague and ‘hand-waving’, a little too much like alternative therapists talking about chi-lines, auras and charkas. It turns out they probably work by binding to certain receptors in the brain, which usually bind Gamma-Aminobutyric Acid (mercifully shortened to GABA). This chemical has an endogenous calming effect, so it is perhaps not surprising that this system is involved. Interestingly alcohol works through the same family of receptors, so our rum toting surgical brethren had something right.

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