| Unresponsiveness ≠ Unconsciousness. | |
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MedLine Citation:
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PMID: 22314293 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Consciousness is a 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 unconsciousness or disconnection of consciousness from the environment. Review of the isolated forearm technique demonstrates that consciousness, connectedness, and responsiveness uncouple during anesthesia; in clinical conditions, a median 37% of patients demonstrate connected consciousness. We describe potential neurobiological constructs that can explain this phenomenon: during light anesthesia the subcortical mechanisms subserving spontaneous behavioral responsiveness are disabled but information integration within the corticothalamic network continues to produce consciousness, and unperturbed norepinephrinergic signaling maintains connectedness. These concepts emphasize the need for developing anesthetic regimens and depth of anesthesia monitors that specifically target mechanisms of consciousness, connectedness, and responsiveness. |
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Authors:
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Robert D Sanders; Giulio Tononi; Steven Laureys; Jamie Sleigh |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-6 |
Journal Detail:
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Title: Anesthesiology Volume: - ISSN: 1528-1175 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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* Medical Research Clinical Training Fellow, Department of Anaesthetics, Intensive Care & Pain Medicine and Department of Leucocyte Biology, Imperial College London, London, United Kingdom. † Professor, Department of Psychiatry, University of Wisconsin Madison, Madison, Wisconsin. ‡ Professor, Coma Science Group, Cyclotron Research Centre, University of Liege, and Department of Neurology, University and University Hospital of Liège, Liege, Belgium. § Professor, Department of Anaesthesia, University of Auckland, Waikato Hospital, Hamilton, New Zealand. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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