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General anesthesia is a drug-induced, reversible condition comprised of five behavioral states: unconsciousness, amnesia (loss of memory), analgesia (loss of pain sensation), akinesia (immobility), and maintenance of physiological stability and control of the stress response. As a consequence, every time an anesthesiologist administers anesthesia he/she creates a control system with a human in the loop. Our work shows that a primary mechanism through which anesthetics create these altered states of arousal is by initiating and maintaining highly structured oscillations. These oscillations impair communication among brain regions. We show how these dynamics change systematically with different anesthetic classes, anesthetic dose and with age. As a consequence, we have developed a principled, neuroscience-based paradigm for using the EEG to monitor the brain states of patients receiving general anesthesia and for implementing formal control strategies for maintaining anesthetic state. We will illustrate these strategies with results from actual control experiments.
