Evidence map›Paper›PMID 30883418›Full record

ReviewAnesthesia and analgesia2019

Escape From Oblivion: Neural Mechanisms of Emergence From General Anesthesia.

Max B Kelz, Paul S García, George A Mashour, Ken Solt

Abstract readReview
In one paragraph

Review in Anesthesia and analgesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Review
  5. Review
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  7. Article
  8. Review
  9. Article
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  11. Article
  12. Article
  13. VCP controls KCC2 degradation through FAF1 recruitment and accelerates emergence from anesthesia.Proceedings of the National Academy of Sciences of the United States of America · 2025
    Article
  14. Unexpected role of microglia and P2YPurinergic signalling · 2024
    Article
  15. Acute Ongoing Nociception Delays Recovery of Consciousness from Sevoflurane Anesthesia via a Midbrain Circuit.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2024
    Article
  16. Article
  17. Restoring consciousness with pharmacologic therapy: Mechanisms, targets, and future directions.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2024
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Max B KelzFrom the Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Paul S GarcíaDepartment of Anesthesiology, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, New York, New York.
George A MashourDepartment of Anesthesiology, University of Michigan, Ann Arbor, Michigan.
Ken SoltDepartment of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Funding

Project 4: Mathematical Modeling Studies of Anesthetic ActionP01GM118269 · NIGMS · MASSACHUSETTS GENERAL HOSPITAL · PI BROWN, EMERY N · 2017 to 2021
$9.0M
Redesigning General Anesthesia (Admin Supp)R01GM104948 · NIGMS · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI BOYDEN, EDWARD S., BROWN, EMERY N · 2012 to 2016
$4.4M
NEURONAL BASIS UNDERLYING VOLATILE ANESTHETIC INDUCED HYPNOSISR01GM088156 · NIGMS · UNIVERSITY OF PENNSYLVANIA · PI KELZ, MAX · 2010 to 2021
$3.8M
The Anesthetic Circuitry of the MidbrainR01GM126155 · NIGMS · MASSACHUSETTS GENERAL HOSPITAL · PI SOLT, KEN · 2019 to 2022
$1.5M
OptoanesthesiaR01GM107117 · NIGMS · UNIVERSITY OF PENNSYLVANIA · PI KELZ, MAX · 2014 to 2017
$1.3M
NIGMS NIH HHS P01 GM118269NIGMS NIH HHS R01 GM088156NIGMS NIH HHS R01 GM104948NIGMS NIH HHS R01 GM107117NIGMS NIH HHS R01 GM126155
6 · The paper itself

Abstract

The question of how general anesthetics suppress consciousness has persisted since the mid-19th century, but it is only relatively recently that the field has turned its focus to a systematic understanding of emergence. Once assumed to be a purely passive process, spontaneously occurring as residual levels of anesthetics dwindle below a critical value, emergence from general anesthesia has been reconsidered as an active and controllable process. Emergence is driven by mechanisms that can be distinct from entry to the anesthetized state. In this narrative review, we focus on the burgeoning scientific understanding of anesthetic emergence, summarizing current knowledge of the neurotransmitter, neuromodulators, and neuronal groups that prime the brain as it prepares for its journey back from oblivion. We also review evidence for possible strategies that may actively bias the brain back toward the wakeful state.

Indexed as

Anesthesia, GeneralAcetylcholineAdenosineAnesthesia Recovery PeriodAnesthetics, GeneralAnimalsArousalBrainConsciousnessDopaminegamma-Aminobutyric AcidHumansNeuronsNeurotransmitter AgentsNorepinephrineOrexinsAcetylcholineAdenosineAnesthetics, GeneralDopaminegamma-Aminobutyric AcidNeurotransmitter AgentsNorepinephrineOrexins

Identifiers

PMID30883418
PMCPMC6885009

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.