British journal of anaesthesia
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This article reviews the actions of general anaesthetics on synapses in the mammalian central nervous system. It is shown that during general anaesthesia, anaesthetics act primarily on the chemical transmission process itself and do not affect the conduction of impulses in nerve axons or change the electrical excitability of neurones. ⋯ In addition to these effects on the neurosecretory process, anaesthetics directly affect the sensitivity of the postsynaptic receptors to transmitter substances, although the effects vary between anaesthetics and receptors. It is concluded that general anaesthesia results from a summation of a number of effects which together tend to depress the excitability of the CNS as a whole.