Core body temperature is highly regulated in humans by the autonomic nervous system and the hypothalamus. General anesthesia, neuraxial anesthesia and analgesia, and drugs such as opioids all reduce the ability of the hypothalamus to regulate core temperature. Thus without…
The autonomic nervous system (ANS) maintains homeostasis by integrating signals from peripheral and central sensors to modulate organ perfusion and function. Autonomic “tone” maintains cardiac muscle, visceral organs, and vascular smooth muscle in a state of intermediate function. From this…
Historical Considerations A specialized taxonomy of the autonomic nervous system (ANS) has been developing since the time of Galen ( ad 130–200). In the early 1900s, Langley first referred to the ANS. He used the term sympathetic nervous system (SNS)…
Historical Perspective In 2016, 395 million prescriptions for drugs used in the treatment of mental health were dispensed in the United States. A further 387 million prescriptions were dispensed for other neurologic disorders. Combining these two therapeutic classes, neuropharmacologic agents…
This chapter focuses on the pharmacology of the inhaled anesthetics, including their mechanisms of action and clinical effects (pharmacodynamics). Related pharmacokinetic principles of inhaled anesthetics are covered in Chapter 3 . Historical Perspective Discovery of Inhaled Anesthetics The German physician…
History of Intravenous Anesthesia The concept of blood delivery of medication can be traced to the middle of the 17th century soon after Harvey described the function of the vascular system. Not only did Sir Christopher Wren study blood transfusions…
This chapter focuses on central nervous system (CNS) physiology and pharmacology relevant to anesthesiology. The molecular and cellular substrates of specific drugs affecting the nervous system are covered in Chapter 8 and in the appropriate chapters in this section. Cerebrovascular…
The neuron is the fundamental unit of information processing and transfer in the central nervous system (CNS). It is, however, the collective activity of hierarchically organized neuronal circuits and networks that underlies its behavioral and homeostatic functions. These functions are…
Definition No medicine is risk free, yet the definition of an adverse drug reaction may not be straightforward. The World Health Organization (1972 Technical Report No. 498) defines an adverse drug reaction as “A response to a drug which is…
History Pharmacology is characterized by detailed descriptions of the actions of individual drugs. In the case of anesthesia, no single drug has been found to be universally satisfactory and indeed general anesthesia is now regarded as a set of desirable…