From the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts (E.D.M., O.A.M., K.N., R.K., C.J.N., K.S.) the Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts (E.D.M., O.A.M., R.K., C.J.N., K.S.) the Department of Brain and Cognitive Sciences (E.D.M., O.A.M., R.K., C.J.N., K.S.) the Institute for Medical Engineering and Science (K.N.), Massachusetts Institute of Technology, Cambridge, Massachusetts.
Anesthesiology. 2020 Jul;133(1):19-30. doi: 10.1097/ALN.0000000000003279.
The neural circuits underlying the distinct endpoints that define general anesthesia remain incompletely understood. It is becoming increasingly evident, however, that distinct pathways in the brain that mediate arousal and pain are involved in various endpoints of general anesthesia. To critically evaluate this growing body of literature, familiarity with modern tools and techniques used to study neural circuits is essential. This Readers' Toolbox article describes four such techniques: (1) electrical stimulation, (2) local pharmacology, (3) optogenetics, and (4) chemogenetics. Each technique is explained, including the advantages, disadvantages, and other issues that must be considered when interpreting experimental results. Examples are provided of studies that probe mechanisms of anesthesia using each technique. This information will aid researchers and clinicians alike in interpreting the literature and in evaluating the utility of these techniques in their own research programs.
尽管人们对决定全身麻醉不同终点的神经回路仍不完全了解,但越来越明显的是,大脑中介导觉醒和疼痛的不同通路与全身麻醉的各种终点有关。为了批判性地评估这一日益增多的文献,熟悉用于研究神经回路的现代工具和技术至关重要。本文读者工具包(Readers' Toolbox article)介绍了四种此类技术:(1)电刺激,(2)局部药理学,(3)光遗传学,和(4)化学遗传学。每种技术都有解释,包括在解释实验结果时必须考虑的优点、缺点和其他问题。本文还提供了使用每种技术研究麻醉机制的示例。这些信息将帮助研究人员和临床医生解读文献,并评估这些技术在他们自己的研究计划中的效用。