Psychedelics and neuroanesthesia: A narrative review of converging mechanisms
Journal of Scientific Innovations in Anesthesiology January 1, 2026 Kunal Kumar Sharma
Anesthesia and psychedelics both disrupt the default-mode network, reduce frontoparietal connectivity, increase between-network interactions, and produce similar EEG signatures, particularly during emergence from anesthesia. Classical serotonergic psychedelics target 5-HT2A receptors, ketamine blocks NMDA receptors, and nitrous oxide modulates GABA-A receptors, yet all produce comparable network-level cortical effects. The controlled setting of anesthesia provides a platform to separate drug pharmacology from expectancy and subjective experience, as demonstrated by ketamine trials masked by surgical anesthesia. This narrative review synthesizes evidence on shared molecular targets, neural-network signatures, and EEG correlates, with implications for perioperative monitoring, sedation in vulnerable patients, and designing placebo-controlled psychedelic studies.