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. 2022 Oct 26;17(4):343–351. doi: 10.17085/apm.22227

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Copyright © the Korean Society of Anesthesiologists, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Fig. 1. — Similarities and differences in the mechanism of action of general anesthesia and sleep. General anesthesia and sleep have similar properties, as there is some degree of overlap in their neuronal circuitry. Sleep and anesthesia can be initiated by inhibiting the wake-promoting pathway or activating the sleep-promoting pathway. However, other mechanisms are thought to be used to reach the “Unconscious, Not arousable” state by general anesthesia, but the exact mechanism is not yet understood. LC: locus coeruleus, DRN: dorsal raphe nuclei, PPT: pedunculopontine tegmental nucleus, LDT: laterodorsal tegmental nucleus, VTA: ventral tegmental area, PB: parabrachial nucleus, TMN: tuberomammillary nuclei, LH: lateral hypothalamus, BF: basal forebrain, VLPO: ventrolateral preoptic area, PZ: parafacial zone, nNOS: neuronal nitric oxide synthase (nNOS)-containing neurons in the cortex, PPT: pedunculopontine tegmental nucleus, LDT: laterodorsal tegmental nucleus, SLD: sublaterodorsal nucleus. Figure were created using BioRender.com.