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Anesthesiology

ISSN 1528-1175

35 papers in the library · 4,163 citations · publishing 1988-2026

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This Month in Anesthesiology

Anesthesiology June 9, 2026

21 Feasibility of a Multicomponent Protocol to Promote Dreaming during Surgical AnesthesiaImage: A. Johnson, Vivo Visuals Studio.Implementation of a treatment bundle consisting of verbal priming, propofol infusion, electroencephalography-guided titration, 10 min or longer of minimization of stimulation, and immediate dream interviews resulted in a high incidence of reported dreaming. Apart from...

Anesthesiology

Anesthesiology June 9, 2026

ON THE COVER: Dreaming during anesthesia is common and may have mental health benefits. However, systematic research on its incidence and outcomes in clinical settings remains limited. In this issue of Anesthesiology, Sikka et al. implemented a standardized propofol-based, electroencephalography-guided emergence bundle to facilitate a preemergence state conducive to dreaming, integrating it...

Feasibility of a Multicomponent Protocol to Promote Dreaming during Surgical Anesthesia

Anesthesiology February 3, 2026 Pilleriin Sikka, May Ching Ngo, Sherry Hu et al. 1 citation

BACKGROUND: Dreaming during anesthesia is common and may have mental health benefits. However, systematic research on its incidence and outcomes in clinical settings remains limited. This study implemented a standardized propofol-based, electroencephalography (EEG)-guided emergence bundle to facilitate a preemergence state conducive to dreaming, integrating it into routine care to assess...

Role of Supramammillary Nucleus Glutamatergic Neurons in Modulating Consciousness Transitions during Propofol Anesthesia in Mice.

Anesthesiology October 1, 2025 Jia-Yan Li, Ye-Hui Wu, Yi-Han Wang et al.

Glutamatergic neurons in the supramammillary nucleus (SuM) have previously been shown to be pivotal parts of the wakefulness-sleep regulation system. However, whether they play a role in propofol-mediated modulation of consciousness remains unclear. This study hypothesized that glutamatergic neurons in the SuM contribute to the regulation of altered states of consciousness under propofol...

Repurposing General Anesthetic Drugs to Treat Depression: A New Frontier for Anesthesiologists in Neuropsychiatric Care.

Anesthesiology August 1, 2024 Connor T A Brenna, Benjamin I Goldstein, Carlos A. Zarate et al. 19 citations

During the last 100 years, the role of anesthesiologists in psychiatry has focused primarily on facilitating electroconvulsive therapy and mitigating postoperative delirium and other perioperative neurocognitive disorders. The discovery of the rapid and sustained antidepressant properties of ketamine, and early results suggesting that other general anesthetic drugs (including nitrous oxide,...

Consciousness and the Dying Brain.

Anesthesiology June 1, 2024 George A. Mashour, UnCheol Lee, Dinesh Pal et al. 8 citations

The near-death experience has been reported since antiquity and is often characterized by the perception of light, interactions with other entities, and life recall. Near-death experiences can occur in a variety of situations, but they have been studied systematically after in-hospital cardiac arrest, with an incidence of 10 to 20%. Long attributed to metaphysical or supernatural causes, there...

State-related Electroencephalography Microstate Complexity during Propofol- and Esketamine-induced Unconsciousness.

Anesthesiology May 1, 2024 Zhenhu Liang, Bo Tang, Yu Chang et al. 13 citations

Identifying the state-related "neural correlates of consciousness" for anesthetics-induced unconsciousness is challenging. Spatiotemporal complexity is a promising tool for investigating consciousness. The authors hypothesized that spatiotemporal complexity may serve as a state-related but not drug-related electroencephalography (EEG) indicator during an unconscious state induced by different...

Use of Psychedelics for Pain: A Scoping Review.

Anesthesiology October 1, 2023 Akash Goel, Yeshith Rai, Shayan Sivadas et al. 29 citations

Chronic pain is a public health concern that affects approximately 1.5 billion people globally. Conventional therapeutic agents including opioid and non-opioid analgesics have been associated with adverse side effects, issues with addiction, and ineffective analgesia. Novel agents repurposed to treat pain via different mechanisms are needed to fill the therapeutic gap in chronic pain...

Ketamine Pharmacodynamics Entangled: Comment.

Anesthesiology December 1, 2022 T. Andrew Bowdle, Nathan Sackett, Rick J. Strassman et al. 5 citations

We read with interest the study of ketamine psychedelic and analgesic effects by Olofsen et al.1 and the accompanying editorial by Mashour.2 In both articles, the authors refer to the “dissociative” effects of ketamine. Corssen and Domino3 originally used the term “dissociative” in 1966 to describe “patients and subjects who, during recovery from CI-581 [ketamine], felt as though they were in...

Ketamine Pharmacodynamics Entangled: Reply

Anesthesiology September 12, 2022 Albert Dahan, Erik Olofsen, Thomas K. Henthorn et al. 3 citations

We thank Bowdle et al.1 for their interest in our article,2 and for the important issue they raise, paraphrased as follows: what is the best anthropocentric description of the "mind-altering" effects of a heterogeneous group of compounds and drugs that act at the brain and cause significant changes in mental state. The group of drugs that we are referring to includes N-methyl-d-aspartate (NMDA)...

Ketamine Analgesia and Psychedelia: Can We Dissociate Dissociation?

Anesthesiology March 18, 2022 George A. Mashour 29 citations

Editorial| May 2022 Ketamine Analgesia and Psychedelia: Can We Dissociate Dissociation? George A. Mashour, M.D., Ph.D. George A. Mashour, M.D., Ph.D. Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan. Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information Accepted for publication February 11, 2022....

Ketamine Psychedelic and Antinociceptive Effects Are Connected

Anesthesiology February 21, 2022 Erik Olofsen, Jasper Kamp, Thomas K. Henthorn et al. 33 citations

BACKGROUND: Ketamine produces potent analgesia combined with psychedelic effects. It has been suggested that these two effects are associated and possibly that analgesia is generated by ketamine-induced dissociation. The authors performed a post hoc analysis of previously published data to quantify the pharmacodynamic properties of ketamine-induced antinociception and psychedelic symptoms. The...

Consciousness, Anesthesia, and Acetylcholine

Anesthesiology February 26, 2021 D. Pal, George A. Mashour

Although the precise neural correlates of consciousness have not yet been identified, there is one neurochemical marker that appears to track with our capacity to experience something: acetylcholine concentration in the cerebral cortex. Cortical acetylcholine concentration is high during wakefulness, decreases during slow-wave sleep, and increases again during rapid eye movement sleep, when we...

Piercing the Ketamine Cloud.

Anesthesiology September 18, 2020 Boris D. Heifets 3 citations

IF ketamine were an animal, it would have to be an octopus: unique, endlessly mutable, potentially dangerous, devilishly complicated to study, and seeming to extend its grasp into every corner of medicine. In the 50 years ketamine has been commercially available in the United States, practitioners and researchers have called it an analgesic, antidepressant, anti-inflammatory agent, dissociative...

The dissociative and analgesic properties of ketamine are independent

Anesthesiology September 4, 2020 Jacob Gitlin, Shubham Chamadia, J. Locascio et al. 48 citations

Background: Ketamine is a dissociative anesthetic with analgesic properties. Ketamine’s analgesic properties have been suggested to result from its dissociative properties. To the authors’ knowledge, this postulate is unsubstantiated. The authors hypothesize that the dissociative and analgesic properties of ketamine are independent. Methods: The authors conducted a single-site, open-label study...

Source-level Cortical Power Changes for Xenon and Nitrous Oxide–induced Reductions in Consciousness in Healthy Male Volunteers

Anesthesiology February 6, 2020 Andria Pelentritou, Levin Kuhlmann, John Cormack et al. 15 citations

BACKGROUND: Investigations of the electrophysiology of gaseous anesthetics xenon and nitrous oxide are limited revealing inconsistent frequency-dependent alterations in spectral power and functional connectivity. Here, the authors describe the effects of sedative, equivalent, stepwise levels of xenon and nitrous oxide administration on oscillatory source power using a crossover design to...

Anesthetic Action and "Quantum Consciousness": A Match Made in Olive Oil.

Anesthesiology August 1, 2018 S. Hameroff

Anesthesiology, V 129 • No 2 228 August 2018 A NESTHETIC gases block consciousness selectively, sparing nonconscious brain activities, and thus their specific action could unravel the age-old mystery of how the brain generates, or mediates, consciousness. In this issue, Li et al.1 make a significant contribution to our understanding of both anesthesia and consciousness, showing that an isotope...

Resting-state Network-specific Breakdown of Functional Connectivity during Ketamine Alteration of Consciousness in Volunteers

Anesthesiology August 9, 2016 Vincent Bonhomme, Audrey Vanhaudenhuyse, Athena Demertzi et al. 206 citations

BACKGROUND: Consciousness-altering anesthetic agents disturb connectivity between brain regions composing the resting-state consciousness networks (RSNs). The default mode network (DMn), executive control network, salience network (SALn), auditory network, sensorimotor network (SMn), and visual network sustain mentation. Ketamine modifies consciousness differently from other agents, producing...

Psychedelics, Glutamate, and Neuroimaging Studies

Anesthesiology May 21, 2014 Rafael G. Dos Santos 1 citation

The article by Icaza and Mashour1 is a very interesting article because it presents a topic of investigation that is currently attracting the attention of pharmacologists, neuroscientists, and biological psychiatrists around the globe: human research with psychedelic compounds. The text brings important information regarding the history and pharmacology of psychedelics but presents important...

Altered States

Anesthesiology September 21, 2013 Eduardo E. Icaza, George A. Mashour 11 citations

Abstract The psychedelic experience has been reported since antiquity, but there is relatively little known about the underlying neural mechanisms. A recent neuroimaging study on psilocybin revealed a pattern of decreased cerebral blood flow and functional disconnections that is surprisingly similar to that caused by various anesthetics. In this article, the authors review historical examples...

Reconfiguration of Network Hub Structure after Propofol-induced Unconsciousness

Anesthesiology September 7, 2013 Heonsoo Lee, George A. Mashour, Gyu‐jeong Noh et al. 153 citations

INTRODUCTION: General anesthesia induces unconsciousness along with functional changes in brain networks. Considering the essential role of hub structures for efficient information transmission, the authors hypothesized that anesthetics have an effect on the hub structure of functional brain networks. METHODS: Graph theoretical network analysis was carried out to study the network properties of...

Disruption of Frontal–Parietal Communication by Ketamine, Propofol, and Sevoflurane

Anesthesiology May 22, 2013 UnCheol Lee, Seungwoo Ku, Gyu‐jeong Noh et al. 436 citations

INTRODUCTION: Directional connectivity from anterior to posterior brain regions (or "feedback" connectivity) has been shown to be inhibited by propofol and sevoflurane. In this study the authors tested the hypothesis that ketamine would also inhibit cortical feedback connectivity in frontoparietal networks. METHODS: Surgical patients (n = 30) were recruited for induction of anesthesia with...

Effect of Subanesthetic Ketamine on Intrinsic Functional Brain Connectivity

Anesthesiology August 13, 2012 Marieke Niesters, Najmeh Khalili‐mahani, Christian H. Martini et al. 141 citations

Background The influence of psychoactive drugs on the central nervous system has been investigated with positron emission tomography and task-related functional magnetic resonance imaging. However, it is not known how these drugs affect the intrinsic large-scale interactions of the brain (resting-state functional magnetic resonance imaging connectivity). In this study, the effect of low-dose...

Unresponsiveness ≠ Unconsciousness

Anesthesiology February 7, 2012 Robert D. Sanders, Giulio Tononi, Steven Laureys et al. 478 citations

Consciousness is subjective experience. During both sleep and anesthesia, consciousness is common, evidenced by dreaming. A defining feature of dreaming is that, while conscious, we do not experience our environment; we are disconnected. Besides inducing behavioral unresponsiveness, a key goal of anesthesia is to prevent the experience of surgery (connected consciousness), by inducing either...

Propofol enhances memory formation via an interaction with the endocannabinoid system.

Anesthesiology June 1, 2011 Daniela Hauer, Patrizia Ratano, Maria Morena et al.

Propofol is associated with postoperative mood alterations and induces a higher incidence of dreaming compared with other general anesthetics. These effects might be mediated by propofol's inhibitory action on fatty acid amide hydrolase, the enzyme that degrades the endocannabinoid anandamide. Because propofol is also associated with a higher incidence of traumatic memories from perioperative...