Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Oct 2011
ReviewInfluence of anesthesia on cerebral blood flow, cerebral metabolic rate, and brain functional connectivity.
To describe recent studies exploring brain function under the influence of hypnotic anesthetic agents, and their implications on the understanding of consciousness physiology and anesthesia-induced alteration of consciousness. ⋯ Accumulating evidence suggests that hypnotic anesthetic agents disrupt large-scale cerebral connectivity. This would result in an inability of the brain to generate and integrate information, while external sensory information is still processed at a lower order of complexity.
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Curr Opin Anaesthesiol · Oct 2011
ReviewPlacebo analgesia and beyond: a melting pot of concepts and ideas for neuroscience.
In the last two decades, some of the neuroanatomical and neurophysiological substrates of the placebo effect have been elucidated. What has emerged is the multifactorial nature of the placebo effect, such that there is not a single placebo effect but many. Here we report on recent advances in our understanding of this phenomenon, with particular emphasis on its use as an experimental model to better clarify different brain mechanisms. ⋯ The study of the placebo effect is paying dividends and bodes well for the future. Whereas in clinical practice it can increase the efficacy of a therapy, in the experimental setting it represents an excellent tool for neuroscience.
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Trauma, surgery, and burns are three common clinical scenarios that are associated with significant acute pain. This review describes the pathophysiology of acute pain utilizing three preclinical models: surgery, burn, and fracture. ⋯ Peripheral mediators of acute pain can vary depending upon the type of injury. Treatment aimed toward those mediators specific to the injury may improve acute pain management in the future. It will be important to translate these findings into clinical trials in the future.