Linear thinking does not reflect the newer 21st-century

J Clin Monit Comput · Oct 2023

Review

Linear thinking does not reflect the newer 21st-century anesthesia concepts. A narrative review.

The brain constitutes a good example of a chaotic, nonlinear biological system where large neuronal networks operate chaotically with random connectivity. This critical state is significantly affected by the anesthetic loss of consciousness induced by drugs whose pharmacological behavior has been classically based on linear kinetics and dynamics. Recent developments in pharmacology and brain monitoring during anesthesia suggest a different view that we tried to explore in this article. The concepts of effect-site for hypnotic drugs modeling a maximum effect, electroencephalographic dynamics during induction, maintenance, and recovery from anesthesia are discussed, integrated into this alternative view, and how it may be applied in daily clinical practice.

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- Pablo O Sepúlveda, Rodrigo Vera, M Silvia Fernández, and Francisco A Lobo.
- Hospital Base San José de Osorno, Chile, Universidad Austral de Chile, Osorno, Chile. pasevou@gmail.com.
- J Clin Monit Comput. 2023 Oct 1; 37 (5): 113311441133-1144.
AbstractThe brain constitutes a good example of a chaotic, nonlinear biological system where large neuronal networks operate chaotically with random connectivity. This critical state is significantly affected by the anesthetic loss of consciousness induced by drugs whose pharmacological behavior has been classically based on linear kinetics and dynamics. Recent developments in pharmacology and brain monitoring during anesthesia suggest a different view that we tried to explore in this article. The concepts of effect-site for hypnotic drugs modeling a maximum effect, electroencephalographic dynamics during induction, maintenance, and recovery from anesthesia are discussed, integrated into this alternative view, and how it may be applied in daily clinical practice.© 2023. The Author(s), under exclusive licence to Springer Nature B.V.

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Linear thinking does not reflect the newer 21st-century anesthesia concepts. A narrative review.

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