Propofol as a Widely Used Anesthetic

What are three different kinds of anesthesia? What is the neurological mechanism of the anesthesia? Why can’t anesthesiology be brought down to simple pharmacology? These and other questions are answered by an MIT professor of Health Sciences and Technology, Emery Brown.

Propofol is one of the most widely used anesthetics. I think it came to probably the public conscious in the United States and around the world in the wake of, you know, Michael Jackson’s unfortunate death, because it was the drug that he had taken, that was administrated to him and was responsible for his death. How does it work? How does it create the state that, you know, we call ‘anesthesia’? Well, anesthesiologists use it in probably two ways, maybe three, let’s say.

When you administer propofol, you actually see two very prominent oscillations: you see one at ten cycles per second, like that, and you see one at about less than one cycle per second – a slow oscillation. What we’ve figured out in our research is a little bit about how these oscillations come about. And we’ve done this by doing some modelling studies and also studying this in humans as well as in animals.

I think, studying the question of general anesthesia really epitomizes the systems neuroscience approach, because it really involves having an interdisciplinary team. Anesthesiology is a field of clinical neuroscience. In other words, no one manipulates the brain on a day-to-day basis more than anesthesiologists, no one manipulates the brain more profoundly than anesthesiologists on a day-to-day basis. Yet it’s been viewed and we practice it as if it’s a field of pharmacology. It certainly is, a lot of what we do involves using pharmacopoeia, involves using drugs. But in point of fact, anesthesiology is a branch of clinical neuroscience, along with neurology, psychiatry, psychology, neurosurgery and, let’s say, sleep medicine.