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    "segs": [ {
      "utf8": "If you've had surgery,"
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    "segs": [ {
      "utf8": "you might remember starting to count\nbackwards from ten,"
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  }, {
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    "segs": [ {
      "utf8": "and then waking up with the surgery\nalready over before you even got to five."
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    "segs": [ {
      "utf8": "And it might seem like you were asleep,\nbut you weren't."
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    "segs": [ {
      "utf8": "You were under anesthesia,"
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  }, {
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    "segs": [ {
      "utf8": "which is much more complicated."
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  }, {
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    "segs": [ {
      "utf8": "but you also couldn't move,"
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  }, {
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      "utf8": "form memories,"
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  }, {
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    "segs": [ {
      "utf8": "or, hopefully, feel pain."
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    "segs": [ {
      "utf8": "Without being able to block all those\nprocesses at once,"
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    "segs": [ {
      "utf8": "many surgeries would be \nway too traumatic to perform."
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    "segs": [ {
      "utf8": "Ancient medical texts from Egypt,\nAsia and the Middle East"
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    "segs": [ {
      "utf8": "all describe early anesthetics"
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    "segs": [ {
      "utf8": "containing things like opium poppy,"
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    "segs": [ {
      "utf8": "mandrake fruit,"
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  }, {
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    "segs": [ {
      "utf8": "and alcohol."
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    "segs": [ {
      "utf8": "Today, anesthesiologists often combine"
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    "segs": [ {
      "utf8": "regional, inhalational \nand intravenous agents"
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    "segs": [ {
      "utf8": "to get the right balance for a surgery."
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    "segs": [ {
      "utf8": "Regional anesthesia blocks pain signals\nfrom a specific part of the body"
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    "segs": [ {
      "utf8": "from getting to the brain."
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    "segs": [ {
      "utf8": "Pain and other messages travel through\nthe nervous system as electrical impulses."
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    "segs": [ {
      "utf8": "Regional anesthetics work by setting up\nan electrical barricade."
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    "segs": [ {
      "utf8": "They bind to the proteins \nin neurons' cell membranes"
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  }, {
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    "dDurationMs": 2635,
    "segs": [ {
      "utf8": "that let charged particles in and out,"
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  }, {
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    "dDurationMs": 3081,
    "segs": [ {
      "utf8": "and lock out positively charged particles."
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    "segs": [ {
      "utf8": "One compound that does this is cocaine,"
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    "segs": [ {
      "utf8": "whose painkilling effects \nwere discovered by accident"
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  }, {
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    "segs": [ {
      "utf8": "when an ophthalmology intern\ngot some on his tongue."
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      "utf8": "It's still occasionally used \nas an anesthetic,"
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      "utf8": "but many of the more common\nregional anesthetics"
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      "utf8": "have a similar chemical structure\nand work the same way."
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      "utf8": "But for major surgeries where you need\nto be unconscious,"
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    "segs": [ {
      "utf8": "you'll want something that acts\non the entire nervous system,"
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    "segs": [ {
      "utf8": "including the brain."
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    "segs": [ {
      "utf8": "That's what inhalational anesthetics do."
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    "segs": [ {
      "utf8": "In Western medicine, diethyl ether\nwas the first common one."
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      "utf8": "It was best known as a recreational drug"
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  }, {
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    "segs": [ {
      "utf8": "until doctors started to realize that\npeople sometimes didn't notice"
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    "segs": [ {
      "utf8": "injuries they received \nunder the influence."
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      "utf8": "In the 1840s, they started sedating\npatients with ether"
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    "segs": [ {
      "utf8": "during dental extractions and surgeries."
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    "segs": [ {
      "utf8": "Nitrous oxide became popular\nin the decades that followed"
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    "segs": [ {
      "utf8": "although ether derivatives, \nlike sevoflurane, are more common."
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      "utf8": "Inhalational anesthesia is usually \nsupplemented with intravenous anesthesia,"
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      "utf8": "which was developed in the 1870s."
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      "utf8": "Common intravenous agents include\nsedatives, like propofol,"
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      "utf8": "which induce unconsciousness,"
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      "utf8": "and opioids, like fentanyl, \nwhich reduce pain."
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      "utf8": "These general anesthetics \nalso seem to work"
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      "utf8": "by affecting electrical signals\nin the nervous system."
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      "utf8": "Normally, the brain's electrical signals\nare a chaotic chorus"
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      "utf8": "as different parts of the brain\ncommunicate with each other."
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      "utf8": "That connectivity keeps you awake\nand aware."
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      "utf8": "But as someone becomes anesthetized,"
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    "segs": [ {
      "utf8": "There's a lot we still don't know\nabout exactly how this happens."
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      "utf8": "Several common anesthetics bind to\nthe GABA-A receptor in the brain's neurons."
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      "utf8": "Negative charge builds up\nand acts like a log jam,"
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      "utf8": "keeping the neuron from transmitting\nelectrical signals."
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      "utf8": "modern drugs can \nhave serious side effects."
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      "utf8": "to create all the features of anesthesia,"
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      "utf8": "while carefully monitoring\nthe patient's vital signs,"
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      "utf8": "but figuring out how to use it"
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      "utf8": "allowed for the development \nof new and better surgical techniques."
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      "utf8": "reopen blocked arteries,"
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      "utf8": "replace damaged livers and kidneys,"
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