General anaesthetics are some of the most widely used and essential therapeutic agents. However, despite over a century of research, the molecular mechanisms of general anaesthesia in the central nervous system remain elusive. Ketamine (ketamine hydrochloride) has been approved for use in general anaesthesia either alone or in combination with other medications. It is a superb drug for use in short-term medical procedures that do not require skeletal muscle relaxation, and it has approval for the induction of general anaesthesia as a pre-anaesthetic to other general anaesthetic agents. However, Several questions remain unsolved, including the exact identification of the neural substrate of consciousness and its components, the pharmacodynamic interactions between anaesthetic agents, the mechanisms of cognitive alterations that follow an anaesthetic procedure, the identification of an eventual unitary mechanism of anaesthesia-induced alteration of consciousness, the relationship between network effects and the biochemical targets of anaesthetic agents, leading to difficulties in between-studies comparisons. Thus, the glutamate and dopamine systems play distinct roles in terms of neuronal signalling, yet both have proposed to contribute significantly to the pathophysiology of neuropsychiatric diseases. Imaging of the glutamate system and other aspects of research on the dopamine system have produced less consistent findings, potentially due to methodological limitations and the heterogeneity of the disorder. In this review, we discuss the neural circuits through which the two systems interact and how their disruption may cause psychotic symptoms. We also summarize from a molecular perspective of mechanisms of action of ketamine as general anaesthetics on ligand-gated ion channels mediated modulation of dopamine in the brain region.

全身麻醉剂是一些使用最广泛且必不可少的治疗剂。然而，尽管进行了一个多世纪的研究，中枢神经系统中全身麻醉的分子机制仍然难以捉摸。氯胺酮（盐酸氯胺酮）已被批准单独或与其他药物联合用于全身麻醉。这是一种极好的药物，可用于不需要骨骼肌放松的短期医疗程序，并且已被批准用于诱导全身麻醉，作为其他全身麻醉剂的麻醉剂。但是，仍有几个问题尚未解决，包括对意识的神经基质及其成分的准确识别，麻醉剂之间的药效相互作用，麻醉程序后认知改变的机制，麻醉诱导的意识改变的最终统一机制的确定，网络效应与麻醉剂生化目标之间的关系，导致研究之间比较的困难。因此，谷氨酸和多巴胺系统在神经元信号传导方面起着不同的作用，但是两者都已提出对神经精神疾病的病理生理有重要贡献。谷氨酸系统的成像和多巴胺系统研究的其他方面所产生的不一致的发现可能较少，这可能是由于该方法的局限性以及该疾病的异质性所致。在这篇评论中 我们讨论了两个系统相互作用的神经回路，以及它们的破坏如何引起精神病性症状。我们还从氯胺酮的作用机理的分子机制的角度总结了氯胺酮作为全身麻醉药对配体门控离子通道介导的大脑区域多巴胺调节的作用。