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Nithya Karambakkam
Jul 254 min read

The Science of Anesthesia

Audience: Middle and High School Students


Fun Fact: It’s extremely uncommon, but patients can become briefly aware of their surroundings while anesthesia is being administered, which is called “anesthesia awareness”. Photo by Hush Naidoo Jade Photography from Unsplash.


When you imagine a surgery, what comes to mind? Perhaps hospital beds surrounded by trays of surgical instruments. Perhaps doctors rushing around, equipped with personal protection equipment. And, of course, a patient — unconscious and unaware of the snipping and stitching being performed on their body. Surgeries are much safer and easier to perform because the patient is sedated, with the help of an anesthetic. Anesthesia works in the background and is an important but overlooked aspect of surgery, playing a key role in making surgeries painless, common, and reliable.


Anesthesia is a medical procedure that helps alleviate pain for patients during certain medical operations. Medicines used for anesthesia are called anesthetics. However, anesthesia is a very broad term and can be classified into four main types: general anesthesia affects the patient’s whole body and renders them unconscious; sedation induces sleep and relaxation; regional anesthesia affects certain limbs, such as arms or legs; and local anesthesia numbs very small areas like a single tooth. 


Anesthesia is administered in a variety of ways, depending on the specific situation. Patients may inhale gas, have an IV line connected to their bloodstream, have a catheter (a small, flexible tube) inserted, take a topical lotion or spray, or even get eye drops or a skin patch. Once the anesthesia enters the body, it blocks pain signals from reaching the brain.


This can happen in two different ways. It may alter neurotransmitter release or block ion channel proteins. Neurotransmitters are chemicals that pass signals between nerve cells. Some anesthetics cause the release of inhibitory neurotransmitters, chemicals that block signal transmission, or do the opposite and block excitatory neurotransmitters, chemicals that cause transmission. Alternately, anesthetics may change activity of ion channel proteins, which ordinarily pass ions through nerve cells to transmit signals. If ions are blocked from passing through, signals don’t get transmitted. 


Painless surgeries are the norm today, but we take them for granted. About 175 years ago, there were no safe and effective anesthetics, so surgeries were extremely rare and dangerous. That seems impossible to fathom now — you’ve probably had small surgeries or taken anesthesia without realizing it, perhaps for dental work or broken bones. These surgeries were excruciatingly painful before the development of anesthesia. Patients had to be conscious during surgery, and doctors used things like plant bark, ice, and hypnosis to try and alleviate pain. Things only began to change in the late 1800s, with the development of ether, an inhalation anesthetic. As further innovations were made, ether was replaced by nitrous oxide and xenon, and surgeries became common and reliable.


Even though it’s a very mature discipline, there are still opportunities to improve anesthesia. It’s usually safe, but it can go wrong in rare cases and cause memory loss and other complications, including collapsed lungs, nerve damage, postoperative delirium, and malignant hyperthermia. During surgery, highly trained doctors called anesthesiologists have to keep carefully monitoring patients. Doses of anesthetics are very specific to each patient and have to be personalized. In other words, it’s tricky work.


Research is currently being done to improve anesthesia and address these limitations. The goal of anesthesia is to develop drugs that administer anesthesia at a precise level and period of time, returning the patient to full consciousness safely and reliably. To this end, medical nanorobots are being constructed to deliver doses of anesthesia. These tiny robots won’t have any side effects and will target specific nerve receptors to increase precision and minimize anesthetic dosage. In a similar vein, researchers are working towards computer regulation of anesthesia to make the jobs of anesthesiologists much easier and automate patient monitoring. 


Anesthesia has come a long way since the first exhibition of ether in the 1800s, and it has a long road ahead of it. It’s a crucial, underappreciated part of medicine — an integral aspect of surgery. So next time you go to the hospital and sit on that paper-covered chair to remove wisdom teeth or get that gash stitched up, take note of the fact that you’re being exposed to anesthesia, and appreciate its importance. We’re lucky to have it.


Bibliography:

Agarwal, Ankit. “The Future of Anaesthesiology.” Indian Journal of Anaesthesia, vol. 56, no. 6, 2012, p. 524, 


Cleveland Clinic. “Anesthesia: Anesthesiology, Surgery, Side Effects, Types, Risk.” Cleveland Clinic, 30 Sept. 2020, 


cmalvikce. “How Does Anesthesia Work? An Expert Explanation.” Www.sgu.edu, 4 Dec. 2019, www.sgu.edu/blog/medical/how-does-anesthesia-work/. Accessed 14 Feb. 2024.


Johns Hopkins Medicine. “Anesthesia.” Johns Hopkins Medicine, 2019, www.hopkinsmedicine.org/health/treatment-tests-and-therapies/types-of-anesthesia-and-your-anesthesiologist. Accessed 14 Feb. 2024.


National Institute of General Medical Sciences. “Anesthesia.” Nih.gov, 2019, www.nigms.nih.gov/education/fact-sheets/Pages/anesthesia.aspx. Accessed 14 Feb. 2024.


Mary Elizabeth Dallas. “8 Surprising Facts about Anesthesia.” EverydayHealth.com, 30 May 2019, 

Chang, Connie Y., et al. “Ether in the Developing World: Rethinking an Abandoned Agent.” BMC Anesthesiology, vol. 15, no. 1, 16 Oct. 2015, 


Sheffler, Zachary M, and Leela Sharath Pillarisetty. “Physiology, Neurotransmitters.” Nih.gov, StatPearls Publishing, 4 June 2019, 

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