PubMed · 6019287
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M H Dykes, S G Walzer. 1967. Preoperative and postoperative hepatic dysfunction.. https://pubmed.ncbi.nlm.nih.gov/6019287/
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A theory of anaesthesia is presented. It consists of four hypotheses: (1) The occurrence of states of consciousness causally depends on the formation of transient higher-order, self-referential mental representations. The occurrence of such states is identical with the appearance of conscious phenomena. Loss of consciousness will occur, if and only if the brain's representational activity falls below a critical threshold. (2) Mental representations are instantiated by neural cell assemblies. (3) The formation of assemblies involves the activation of the NMDA receptor channel complex. The activation state of this receptor determines the rate at which assemblies are generated. (4) General anaesthetics have a common operative mechanism: they directly or indirectly affect the function of the NMDA system.
A treatment outcome study was conducted to compare the efficacy of cognitive behavior therapy (CBT) versus general anesthesia in alleviating the distress of 18 pediatric cancer patients (ages: 3-12 years) undergoing bone marrow aspirations (BMAs). CBT and short-acting mask anesthesia were delivered within a repeated-measures counterbalance design. Results indicated that children exhibited more behavioral distress in the CBT condition for the 1st minute lying down on the treatment table. However, parents rated significantly more behavioral adjustment symptoms 24 h following the BMA when their children had received anesthesia. No differences were found in childrens' and parents' preference for CBT versus anesthesia.
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