The broad range of dynamics observed in response to propofol administration suggests that propofol-induced unconsciousness is a multifactorial process. In profound states of propofol-induced unconsciousness, the phase of the slow-delta oscillations strongly modulates the amplitude of the alpha oscillations ( Purdon et al., 2013). Concomitantly, coherent alpha oscillations (8–12 Hz) concentrate across the frontal area of the scalp, a process known as anteriorization ( Cimenser et al., 2011 Purdon et al., 2013). At higher doses that maintain unconsciousness for surgery, slow-delta oscillations (0.1–4 Hz) ( Lewis et al., 2012 McCarley, 2007) appear across the entire scalp and are decoupled between cortical regions ( Lewis et al., 2012). At low doses, propofol produces a sedative state associated with beta oscillations (13–25 Hz) ( McCarthy et al., 2008 Purdon et al., 2015). In humans, propofol produces dose-dependent changes in arousal level that are associated with spatiotemporal neurophysiological signatures across the cortex. Propofol – the most widely used anesthetic – acts by enhancing GABAergic inhibition throughout the brain and central nervous system ( Bai et al., 1999 Hapfelmeier et al., 2001 Hemmings et al., 2019 Hemmings et al., 2005).
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