Consciousness and anesthesia: Towards a new integrated paradigm

Abstract

According to reported studies there is increasing evidence that an actual level of anesthesia may exist on a continuum between usual awareness and states of unconsciousness. Recent findings also indicate that levels of anesthesia may be related to specific disturbances in neural correlate of consciousness that is mainly based on large scale synchronization in the brain. Further research studies have also shown that these specific changes during loss of consciousness may be reflected in decreased large scale synchronization in the brain that is caused by decreased cooperation among simultaneously active neural assemblies. In this context, concept of cognitive unbinding has been proposed that is mainly caused by decreased synchronizaton and cooperation among neural assemblies, which leads to decreased level of consciousness and in the extreme case to global anesthesia. Several recent studies suggest that these findings could be very useful for detecting intraoperative awareness which may lead to serious adverse effects and symptoms of posttraumatic stress disorder (PTDS). According to these data episodes of intraoperative awareness could be detected by various techniques focused on detecting binding processes reflecting a level of dependence in neural activation.