General anaesthesia: from molecular targets to neuronal pathways of sleep and arousal

Nat Rev Neurosci. 2008 May;9(5):370-86. doi: 10.1038/nrn2372.


The mechanisms through which general anaesthetics, an extremely diverse group of drugs, cause reversible loss of consciousness have been a long-standing mystery. Gradually, a relatively small number of important molecular targets have emerged, and how these drugs act at the molecular level is becoming clearer. Finding the link between these molecular studies and anaesthetic-induced loss of consciousness presents an enormous challenge, but comparisons with the features of natural sleep are helping us to understand how these drugs work and the neuronal pathways that they affect. Recent work suggests that the thalamus and the neuronal networks that regulate its activity are the key to understanding how anaesthetics cause loss of consciousness.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anesthetics, General / pharmacology*
  • Animals
  • Arousal / drug effects*
  • Arousal / physiology
  • Humans
  • Models, Biological
  • Nerve Net / drug effects
  • Neural Pathways / drug effects*
  • Neural Pathways / physiology
  • Receptors, GABA / drug effects
  • Receptors, GABA / physiology
  • Sleep / drug effects*
  • Sleep / physiology
  • Thalamus / cytology
  • Thalamus / drug effects


  • Anesthetics, General
  • Receptors, GABA