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August 27, 1973

The Neurophysiological Background for Anesthesia

Author Affiliations

National Institutes of Health Bethesda

JAMA. 1973;225(9):1128. doi:10.1001/jama.1973.03220370064037

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This book aims to acquaint anesthetists with the elements of neurophysiology relevant to their discipline, and neurophysiologists with the effects of anesthetic agents on the nervous system. Both objectives, while laudable, are inadequately fulfilled.

Analgesia, amnesia, and muscular relaxation have central importance for anesthetists and are dealt with in separate chapters. The material on analgesia considers the effects of local anesthetic agents but does not include centrally acting analgesic agents. Further chapters on the neurophysiological mechanisms of pain, and on the electrical signs of the effects of anesthetic agents on the brain complete the volume.

The opening chapter on pain provides on acceptable historical perspective, but it deals less capably with recent evidence on the question of specificity in afferent systems related to pain perception. Perhaps too much credence is given to the "gate-control" hypothesis, which has not received recent experimental support. The related accounts of primary afferent depolarization and