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  • I don’t mean to alarm anyone, but we don’t really know exactly how general anesthesia

  • works.

  • We do know THAT it works, and that it’s relatively safe. But scientists are still

  • trying to figure out how all these different chemicals switch out the lights in your brain.

  • Anesthesia is a state where youre insensitive to pain, and doctors use it so that when they

  • need to get to your heart or kidneys or whatever, they can turn something invasive and traumatic

  • into a peaceful nap.

  • General anesthesia is the kind that knocks you out completely -- as opposed to local

  • anesthesia, which just numbs a part of your body for a while, or twilight sedation, where

  • youre technically conscious but won’t remember anything that happened.

  • Usually, general anesthesia involves a combination of two drugs -- the first knocks you out fast,

  • and the other one keeps you that way. The anesthesiologist can fine-tune the dosage

  • of the second drug to make sure you don’t wake up too early, or go too far under.

  • So we know that anesthetics knock you unconscious, and we know that they keep you from feeling

  • pain, responding to your environment and -- almost always -- from remembering what happened.

  • Which is a huge plus, because feeling -- and remembering -- being sliced up and stitched

  • back together would not be pleasant.

  • But anesthesia’s not the same as going to sleep.

  • Some parts of the brain are still active, but unlike when youre fully conscious,

  • those active parts don’t really communicate with each other.

  • The brain patterns of someone under anesthesia don’t look like sleep, either. There’s

  • no rapid eye movement or dreaming under anesthesia.

  • Anesthesia brainwaves actually look a lot like the brainwaves of a coma patientwhich

  • makes sense, because anesthesia is a lot like a coma. It’s just reversible under the doctor’s

  • control.

  • The weird thing is, this same anesthetic state can be brought on by a whole bunch of different

  • chemicals--from the noble gas xenon, to big molecules made up of rings of carbon.

  • Since all these different anesthetics do similar things, scientists figured they must have

  • something in common. And the most obvious one was that they almost all dissolve in oil

  • oils like the insides of your cell membranes.

  • For decades, researchers thought that anesthetics could dissolve in the membranes of your brain

  • cells and disrupt them somehow.

  • But some compounds that are similar to anesthetics and very oil-soluble don’t numb pain. And

  • some anesthetics aren’t very oil-soluble at all.

  • Instead, these days scientists think it has more to do with proteins, which have oily

  • patches too. So anesthetics probably bond to proteins in your brain.

  • But it’s hard to study drugs that bond in an oily environment.

  • Anesthetics bond very weakly to the proteins they act on, and it’s hard to get them to

  • stick in place for long enough to know exactly where theyre stuck.

  • The best understood anesthetic is also one of the most popular: propofol.

  • Propofol binds the receptor for a chemical messenger called GABA, which is involved in

  • controlling sleep and alertness, among other things.

  • Propofol helps activate the brain’s receptors for GABA -- and researchers think it’s especially

  • active in the part of the brain that handles sleep.

  • What we don’t know is exactly how that part of the brain controls consciousness, and how

  • propofol switches it off, and then back on again as soon as it goes away.

  • But, since studies have found that there’s also a bunch of other anesthetics that also

  • bind to the GABA receptor, researchers think theyre on the right track.

  • There is one really strange thing we do know: Redheads need more anesthetic.

  • Doctors have been reporting cases of this for a while, and at least one small study

  • showed that redheads need 19% more anesthetic than people with dark hair.

  • According to the authors of the study, the gene that produces red hair color seems to

  • be related to resistance to anesthetic, especially since it’s also been linked to pain sensitivity.

  • So we don’t really know how general anesthesia works, but it’s a good thing that it does.

  • And as we study it, were going to be learning more about how the brain is put together -- and

  • maybe a little more about gingers.

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I don’t mean to alarm anyone, but we don’t really know exactly how general anesthesia

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