In the 1200s, Italian doctor Theodoric of Lucca reportedly used sponges dipped in opium and mandragora to soften the blow of surgery. These early attempts at anesthesia were better than giving the patient a wooden spoon to bite down on, but they were still merely pain relievers, not a general anesthetic. Fast forward to 1846 at the Massachusetts General Hospital in Boston - William T.G. Morton and John Warren administered sulphuric ether to a patient who then fell into a deep sleep. Huzzah! Modern anesthesiology was born. As a result, intricate surgeries could be performed without the patient writhing in agony.
But how did Morton and Warren’s concoction work? The truth is, they didn't know… and… we still don't. Yep, anesthesiology is a mystery. We do know that the drugs somehow stop our brain cells from chatting to each other, but that’s pretty much the extent of our knowledge. Until very recently...
Experts have long suspected the process involves a protein called syntaxin1A, which hangs out in our nerve cells. So, in 2019, scientists at the University of Queensland conducted experiments on fruit flies (our brains have similar proteins) to help unravel the mystery. They put tiny respiratory masks on the fruit flies - kidding - they introduced propofol and etomidate to the fruit flies' brains, and saw that the syntaxin1A protein was unable to form a SNARE complex - this is something that cells need in order to send signals to one another (aka chat). When our brain goes radio silent, it basically means we fall asleep - or "go under".
Experts are now one step closer to understanding how and why general anesthesia works, but there are still a lot of unknowns. What can we say, we're complicated beasts - anesthesiology is just one more mystery to add to the "things we don't understand about the brain" pile.
Image by National Cancer Institute