General anesthesia redefined surgery and medicine, but over a century later it still carries significant risks. Too much sedation can lead to neurocognitive disorders and may even shorten lifespan; too little can lead to traumatic and painful wakefulness during surgery. So far, scientists have learned that, generally speaking, anesthetic drugs render people unconscious by altering how parts of the brain communicate. But they still don't fully understand why. Although anesthesia works primarily on the brain, anesthesiologists do not regularly monitor the brain when they put patients under. And it is only in the past decade that neuroscientists interested in altered states of consciousness have begun taking advantage of anesthesia as a research tool. "It's the central irony," of anesthesiology, says George Mashour, a University of Michigan neuroanesthesiologist, whose work entails keeping patients unconscious during neurosurgery and providing appropriate pain management.
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