Medical Research Council - London Institute of Medical Sciences

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Secrets of Sedation
26 February 2018

Secrets of Sedation

Depicting one of the first operations using anaesthetics, this photograph represents a medical revolution. Since the pioneering use of ether to provide pain relief in the 1840s, anaesthetics have become an essential and sophisticated component of a surgeon’s toolkit. They block pain by obstructing communication between neurons at synapses, although how exactly they operate is a complicated question. Part of the answer is that anaesthetic drugs clog the receptors for GABA neurotransmitters, key signalling molecules in the nervous system. Known as a post-synaptic mechanism, this prevents downstream neurons from receiving signals. Yet recent research uncovered evidence that anaesthetics may also act pre-synaptically, hindering the release of neurotransmitters in the first place. Propofol, the most commonly-used modern anaesthetic, appears to interfere with a SNARE protein, an essential component of the machinery for neurotransmitter delivery. This suggests a dual action for anaesthetics, affecting both sender and receiver neurons to thwart signal transmission.

Written by Emmanuelle Briolat

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