RT Book, Section A1 Kelz, Max B. A1 Todorovic, Slobodan M. A1 Eckenhoff, Roderic G. A2 Longnecker, David E. A2 Mackey, Sean C. A2 Newman, Mark F. A2 Sandberg, Warren S. A2 Zapol, Warren M. SR Print(0) ID 1144117304 T1 Mechanisms of General Anesthetic Action T2 Anesthesiology, 3e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071848817 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1144117304 RD 2024/03/29 AB KEY POINTSThe mechanisms by which the inhaled general anesthetics work are not fully understood. No single molecular target has proven sufficient to transduce all of the end points associated with anesthesia.Correlation of the physicochemical character of anesthetics with their potency suggests target sites are mostly hydrophobic, with a degree of polarity and chirality. Internal or interfacial protein cavities best fit this description.Inhaled anesthetic binding site character is not highly specific, predicting more than a few anesthetic binding targets. The interaction at some of these targets may not contribute significantly to desired anesthetic end points but may contribute to side effects.Use of the lipid membrane as a direct target for inhaled anesthetics has been dismissed prematurely. Some components of anesthetic action may occur via this interaction.Many potential protein targets in the synaptic regions have been identified, suggesting that inhaled anesthetic action results from disruption of synaptic transmission rather than from a receptor-like interaction with a single molecular target.Anesthetic effects on a process, such as synaptic transmission, may have a different system-level effect depending on placement in the neural circuitry. The circuits that regulate sleep and arousal are well positioned to mediate the hypnotic properties of anesthetics.