Anesthesiology in the 21st century: Analgesic, sedative and anesthetic focusing

  • Theodore H. Stanley
Point of View


The specialty of anesthesiology is on the verge of a major technological evolution (revolution) which will utilize the computative and logic powers of the computer as well as the recent and rapid advances in magnetic imaging and laser and drug receptor technology to introduce the concept of anesthetic drug focusing by the beginning of the next century. This will result in the need for only a few molecules of future anesthetic compounds because they will only be necessary at a limited number of receptors in a few neurons or nuclei in the brain and/or spinal cord. Analgesic, sedative and anesthetic action may not be dependent on any drug but rather be produced solely by a wave form or energy source focused via a computer on the appropriate receptors in the brain, spinal cord or peripheral nerves. Anesthetic drug focusing will enable anesthetic depth to be ideal, anesthetic action to be localized to only those cells, tissues or organs where it is desired and anesthetic onset and termination to be measured in micro-seconds.


analgesic anesthetic and sedative hypnotic focusing drug focusing laser magnetic imaging receptor neurotransmitters 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bangham AD: Introduction. In Liposomes: From Physical Structure to Therapeutic Applications, Knight (ed), Elsevier/North-Holland Biomedical Press, The Hague, 1981, Chapt 1.Google Scholar
  2. 2.
    Bangham AD: Liposomes in Nuce. Biol Cell 47: 1–10, 1983.Google Scholar
  3. 3.
    Bartholini G, Pletocher A: Cerebral accumulation and metabolism of C14-Copa after selective inhibition of peripheral decarboxylose. J Pharmacol Exp ther 161: 14–20 1968.PubMedGoogle Scholar
  4. 4.
    Bovill J, Sebel P, Stanley TH: Opioid analgesic in anesthesia: With particular reference to their use in cardiovascular anesthesia. Anesthesiology 61: 731–755, 1984.PubMedCrossRefGoogle Scholar
  5. 5.
    Cammoun D, Hendee WR, Davis KA: Clinical applications of magnetic resonance imaging-Current status. W J Med 143: 793–803, 1985.Google Scholar
  6. 6.
    Chan L: The current status of magnetic resonance spectroscopy-Basic and clinical aspects. W J Med 143: 773–781, 1985.Google Scholar
  7. 7.
    Chen G, Ensoi CR, Bohner B: Drug effects on the disposition of active biogenic amines in the CNS. Life Sci 7: 1063–1074, 1968.PubMedCrossRefGoogle Scholar
  8. 8.
    De Castro J, Van de Water A, Wouters L, Xhonneux R, Reneman R, Kay B: Comparative study of cardiovascular neurological and metabolic side effects of eight narcotics in dogs. Acta Anaesthesiology Belg 30: 5–99, 1979.Google Scholar
  9. 9.
    Dixon JA, Gilbertson JJ: Cutaneous laser therapy. W J Med 143: 745–750, 1985.Google Scholar
  10. 10.
    Hahn EF, Pasternak GW: Stereochemistry of opiates and their receptors. In Handbook of stereoisonomers. Smith D (ed). Boca Raton. CRC Press, 1983.Google Scholar
  11. 11.
    Haigler HJ, Adnojanian GK: Serotonin receptors in the brain. Fed Proc 36: 2159–2164, 1977.PubMedGoogle Scholar
  12. 12.
    Haveman U, Kuschinsky K: Neurochemical aspects of the opioid induced ‘catatonia’. Neurochem Inter 4: 199–215, 1982.CrossRefGoogle Scholar
  13. 13.
    Haveman U, Turski L, Schwaz M, Kuschinsky K: On the role of GABA-ergic mechanisms in striatum and substantia nigra in mediating muscular ridigity. Naunyn-Schmiedeberg's Arch Pharmac 322 (suppl): 373, 1983.Google Scholar
  14. 14.
    Hause L, Sances A, Larson S: Polarization changes induced in the pyramidal cell and other neural elements by externally applied fields. In The Nervous System and Electrical Currents, Wielfsohn NL and Sances A (eds), Plenum Press, New York, 1971, pp 93–95.Google Scholar
  15. 15.
    Kirkpatrick A, Johansson J, Fiserova-Bergerova Y: Ultralong local anesthesia with lecithin-coated methoxyflurane. Anesthesiology 63: A218, 1985.CrossRefGoogle Scholar
  16. 16.
    Knigge KM, Joseph SA: Anatomy of the opioid-systems of the brain. Can J Neurol Sci 11: 14–23, 1984.PubMedGoogle Scholar
  17. 17.
    Knigge KM, Joseph SA, Norton J: Topography of the ACTH-immunoreactive neurons in the basal hypothalamus of the rat brain. Brain Res 216: 333–314, 1981.PubMedCrossRefGoogle Scholar
  18. 18.
    Kuhan MJ, Pasternak GW: Analgesics: Neurochemical, behavioral and clinical perspectives. New York: Raven Press, 1984.Google Scholar
  19. 19.
    Leduc S: L'electrisation cerebrale. Arch Elec Med 11: 403–410, 1903.Google Scholar
  20. 20.
    Leysen JE, Laduron PM: Receptor binding properties in vitro and in vivo of some long-acting opiates. Arch Int Pharmacodyn Ther 232: 343–346, 1978.Google Scholar
  21. 21.
    Leysen JE, Tollenoere JP, Koch MHJ, Laduran P: Differentiation of opiate and neurolept receptor binding in rat brain. Eur J Pharmacol 43: 253–267, 1977.PubMedCrossRefGoogle Scholar
  22. 22.
    Limoge A, Cara A, Debras C: Electrotherapeutic Sleep and Electro-anesthesia. Masson, Paris, 1978.Google Scholar
  23. 23.
    Martin W.: Multiple opioid receptors. Life Sci 28: 1547–1554, 1981.PubMedCrossRefGoogle Scholar
  24. 24.
    Moore RY, Bloom FE: Central catecholamine neuron systems: Anatomy and physiology. Ann Rev Neurosc 1: 129–169, 1978.CrossRefGoogle Scholar
  25. 25.
    Moo-Young GA: Lasers in ophthalmology. W J Med 143: 745–750, 1985.Google Scholar
  26. 26.
    Myers RD, Oeltgen PR, Spurrier WA: Hibernation ‘trigger’ injected into brain induces hypothermia and hypophagia in the monkey. Brain Res Bull 7: 691–695, 1981.PubMedCrossRefGoogle Scholar
  27. 27.
    Niemegeers CJE, Schellekens KHL, Van Bever WFM, Janssen PAG: Sufentanil a very potent and extremely safe intravenous morphine-like compound in mice, rats and dogs. Drug Res 26: 1551–1556, 1976.Google Scholar
  28. 28.
    Pasternak GW: Opiate enkephalin and endorphin analgesia: Relations to a single subpopulation of opiate receptors. Neurology 31: 1311–1315, 1981.PubMedGoogle Scholar
  29. 29.
    Pasternak GW, Childers SR: Opiates, opioid peptides and their receptors. Neurology 31: 1311–1315, 1981.PubMedGoogle Scholar
  30. 30.
    Pasternak GW, Childers SR, Snyder SH: Opiate analgesia: Evidence for mediation by a subpopulation of opiate receptors. Science May 2: 208 (4443): 514–516, 1980.PubMedCrossRefGoogle Scholar
  31. 31.
    Pasternak GW, Childers SR, Snyder SH: Naloxazone, a long-acting opiate antagonist: Effects of analgesia in intact animals and opiate receptor binding in vitro. J Pharmacol Exp Ther 214: 455–462, 1980.PubMedGoogle Scholar
  32. 32.
    Poznansky MJ, Juliano RL: Biological approaches to the control delivery drugs: A critical review. Pharmacological Reviews 36: 277–336, 1984.PubMedGoogle Scholar
  33. 33.
    Regan JD, Parrish JA: The Science of Photomedicine. Plenum Press, New York, 1982.Google Scholar
  34. 34.
    Richter JJ: current theories about the mechanism of benzodizepines and neuroleptic drugs. Anesthesiology 54: 66–72, 1981.PubMedCrossRefGoogle Scholar
  35. 35.
    Scherzinger AL, Hendee WR: Basic principles of magnetic resonance imaging—An update. W J Med 143: 782–792, 1985.Google Scholar
  36. 36.
    Scoggin: The new biomedical technology. West J Med 143: 819–824, 1985.PubMedGoogle Scholar
  37. 37.
    Sjolund B, Eriksson M: Electro-acupuncture and endogenous morphines. Lancet 2: 1085, 1976.PubMedCrossRefGoogle Scholar
  38. 38.
    Synder SH, Goodman RR: Multiple neurotransmitter receptors. J Neurochem 35: 5–15, 1981.CrossRefGoogle Scholar
  39. 39.
    Standaert FG: Magic bullets, science and medicine. Anesthesiology 63: 577–578, 1985.PubMedCrossRefGoogle Scholar
  40. 40.
    Stanley TH, Cazaloa JA, Atinault A, Cozytaux R, Limoge A, Louville Y: Transcutaneous cranial electrical stimulation decreases narcotic requirements during neuroleptanesthesia and operation in man. Anesth Analg 61: 863–866, 1962.Google Scholar
  41. 41.
    Stanley TH, Cazaloa JA, Limoge A, Louville Y: Transcutaneous cranial electrical stimulation increases the potency of N20 in man. Anesthesiology 57: 293–297, 1982.PubMedCrossRefGoogle Scholar
  42. 42.
    Van Bever WFM, Niemegeers CJE, Schellekens KHL, Janssen PAJ: N-4 substituted 1(2–14ylethyl)-4-piperidinyl-N-phenylanamides, a novel series of extremely potent analgesics with unusually high safety margin. Drug Res 26: 1548–1551, 1976.Google Scholar
  43. 43.
    Vander Ark GD, McGrath KA: Transcutaneous electrical stimulation in treatment of postoperative pain. Am J Surg 130: 338–340, 1975.CrossRefGoogle Scholar
  44. 44.
    Verschraegen R, Rossell MT, Bogaert M, Roly G: Maptazind. In: Use in postoperative pain. Acta Anaestheio Belg 27 (suppl): 123–132, 1976.Google Scholar
  45. 45.
    Wofsy D: Strategies for treating autoimmune disease with monoclonal antibodies. W J Med 143: 804–809, 1985.Google Scholar
  46. 46.
    Wood PL, Richard JW, Thakur M: Muropiate isoreceptors: Differentiation with kappa agonists. Life Sci 31: 2313–2317, 1982.PubMedCrossRefGoogle Scholar

Copyright information

© Martinus Nijhoff Publishers 1986

Authors and Affiliations

  • Theodore H. Stanley
    • 1
  1. 1.Department of AnesthesiologyThe University of Utah School of MedicineSalt Lake CityUSA

Personalised recommendations