Disruption of Frontal–Parietal Communication by Ketamine, Propofol, and Sevoflurane
Anesthesiology May 22, 2013 UnCheol Lee, Seungwoo Ku, Gyu‐jeong Noh et al. 436 citations
Ketamine, like propofol and sevoflurane, inhibits feedback (anterior-to-posterior) connectivity between frontal and parietal brain regions after loss of consciousness, while preserving feedforward (posterior-to-anterior) connectivity. In 30 surgical patients given intravenous ketamine (2 mg/kg), electroencephalography showed that feedback connectivity gradually diminished and was significantly reduced after loss of consciousness (mean baseline 0.0074 vs. anesthesia 0.0055). Feedforward connectivity remained unchanged. Ketamine reduced alpha power and increased gamma power, unlike propofol and sevoflurane. Despite molecular and neurophysiologic differences, diverse anesthetics disrupt frontal-parietal communication, suggesting that directional connectivity analysis could provide a common metric for general anesthesia.