Comparative site of action of various anaestetic agents at the mammalian myoneural junction

On Effect of Chloroform on Electrical Activity of Proteinoids

Proteinoids, or thermal proteins, produce hollow microspheres in aqueous solutions. Ensembles of the microspheres produce endogenous spikes of electrical activity, similar to that of neurons. To make the first step toward the evaluation of the mechanisms of such electrical behaviour, we decided to expose proteinoids to chloroform. We found that while chloroform does not inhibit the electrical oscillations of proteinoids, it causes substantial changes in the patterns of electrical activity. Namely, incremental chloroform exposure strongly affects proteinoid microsphere electrical activity across multiple metrics. As chloroform levels rise, the spike potential drops from 0.9 mV under control conditions to 0.1 mV at 25 mg/mL. This progressive spike potential decrease suggests chloroform suppresses proteinoid electrical activity. The time between spikes, the interspike period, follows a similar pattern. Minimal chloroform exposure does not change the average interspike period, while higher exposures do. It drops from 23.2 min under control experiments to 3.8 min at 25 mg/mL chloroform, indicating increased frequency of the electrical activity. These findings might lead to a deeper understanding of the electrical activity of proteinoids and their potential application in the domain of bioelectronics.

Isoflurane depresses hippocampal CA1 glutamate nerve terminals without inhibiting fiber volleys

BACKGROUND

Anesthetic-induced CNS depression is thought to involve reduction of glutamate release from nerve terminals. Recent studies suggest that isoflurane reduces glutamate release by block of Na channels. To further investigate this question we examined the actions of isoflurane, TTX, extracellular Ca2+, CNQX and stimulus voltage (stim) on glutamate-mediated transmission at hippocampal excitatory synapses. EPSPs were recorded from CA1 neurons in rat hippocampal brain slices in response to Schaffer-collateral fiber stimulation.

RESULTS

Isoflurane (350 microM; 1 MAC) reversibly depressed EPSP amplitudes by ~60% while facilitation increased approximately 20%. Consistent with previous studies, these results indicate a presynaptic site of action that involves reduced excitation-release coupling. EPSPs were depressed to comparable levels by TTX (60 nM) or lowered stim, but facilitation was not changed, indicating a simple failure of axonal conduction. Similarly, partial antagonism of postsynaptic glutamate receptors with CNQX (10 microM) depressed EPSP amplitudes with no change in facilitation. However, EPSP depression by low external Ca2+ (0.8 mM) was accompanied by an increase in facilitation comparable to isoflurane. Isoflurane depression of EPSP amplitudes could also be partly reversed by high external Ca2+ (4 mM) that also decreased facilitation. Isoflurane or low Ca2+ markedly reduced the slopes of fiber volley (FV)-EPSP input-output curves, consistent with little or no effect on FVs. By contrast, TTX didn't alter the FV-EPSP curve slope, indicating that EPSP depression resulted from FV depression. FVs were remarkably resistant to isoflurane. Somatic spike currents were unaffected by 350 microM (1 MAC) isoflurane as well. The EC50 for isoflurane depression of FVs was approximately 2.8 mM (12 vol. %; 8 MAC).

CONCLUSION

Isoflurane appears to depress CA1 synapses at presynaptic sites downstream from Na channels, as evident by the increased facilitation that accompanies EPSP depression. Fiber volleys did not exhibit depression by isoflurane, as has been reported for other brain regions.

Awareness in anaesthesia: incidence, consequences and prevention

Awareness during anaesthesia is a state of consciousness that is revealed by explicit or implicit memory of intraoperative events. Although large clinical surveys indicate an incidence of explicit awareness of < 0.3% during anaesthesia for general surgery, this adverse effect should be a great concern, because patients may be permanently disabled by the experience of being awake during surgery. Prevention of awareness during anaesthesia starts with an appropriate preoperative visit to the patient. The anaesthetic delivery machines must be properly checked before and during anaesthesia. The anaesthetic depth should be assessed by observation of movement responses, and consequently a minimum of muscle relaxants used. Because the anaesthetic depth can be controlled by determination of endtidal drug concentration, volatile inhaled anaesthesia may be associated with a lower frequency of awareness than other anaesthetic regimens.

The neuromuscular effects of sevoflurane and isoflurane alone and in combination with vecuronium or atracurium in the rat

Sevoflurane was compared to isoflurane anesthesia alone and in combination with atracurium or vecuronium in 84 rats using the sciatic nerve-anterior tibialis muscle preparation. Both bolus injection and infusion rate techniques were used to evaluate these drug interactions. The ED(50) (dose which produced a 50% depression of twitch tension) of atracurium was 311 +/- 31 and 360 +/- 32 microg.kg(-1) during 1.25 MAC sevoflurane and isoflurane anesthesia respectively. The ED(50) of vecuronium was 190 +/- 27 and 149 +/- 14 microg.kg(-1) during 1.25 MAC sevoflurane and isoflurane anesthesia respectively. The mean infusion rates of atracurium and vecuronium required to maintain a 50% depression of twitch tension were 5.04 +/- 0.7 and 2.02 +/- 0.3 mg.kg(-1).hr(-1). These infusion rates were 5.04 +/- 0.7 and 2.02 +/- 0.3 mg.kg(-1).hr(-1) during 1.25 MAC sevoflurane and 3.73 +/- 0.3 and 1.81 +/- 0.4 mg.kg(-1).hr(-1) during 1.25 MAC isoflurane anesthesia respectively. With both atracurium and vecuronium, the infusion rate required to maintain a 50% depression twitch of tension was inversely related to the concentrations of isoflurane and sevoflurane. The authors conclude that sevoflurane is similar in potency to that of isoflurane in augmenting a vecuronium or atracurium induced neuromuscular blockade in a dose-dependent manner.

Enflurane inhibits muscle fasciculations caused by suxamethonium in children

Eighty-three children with a mean age of 2.7 years were anaesthetized with either thiopental 5 mg/kg followed by suxamethonium 1.5 mg/kg i.v. or with enflurane 5 vol% in 70% nitrous oxide in oxygen via a face mask. In the enflurane group, venepuncture was performed when the children were unconscious, 1.8 +/- 0.05 (s.e.) min after the start of anaesthesia. After enflurane, suxamethonium 1, 1.5 or 2 mg/kg was administered i.v. for endotracheal intubation. The incidence and duration of muscle fasciculations after suxamethonium were significantly lower (P less than 0.01) in the enflurane groups than in the thiopental group. The fasciculation index was significantly lower (P less than 0.01) in the enflurane groups than in the thiopental group. In the enflurane groups, intubating conditions were better (P less than 0.05) in the children treated with suxamethonium 2 mg/kg than in those treated with suxamethonium 1 mg/kg.

The influence of thiopentone and alfathesin on succinylcholine-induced fasciculations and myalgias

Thiopentone doses corresponding to 5.238 mg x kg-1, that is 2UD95 (UD95:unconsciousness dose 95) inhibit the intensity of succinylcholine-induced fasciculations compared with UD95. Alfathesin doses corresponding to 0.570 mg x kg-1, also 2UD95 (calculated as alphaxalone at a concentration of 9 mg/ml in alfathesin), do not have any greater effect on the degree of fasciculations compared to UD95. Furthermore, neither induction agent influences the incidence, distribution and duration of succinylcholine-induced myalgias. The inhibition of the degree of fasciculations caused by thiopentone is believed to be a consequence of a postsynaptic depressant effect of thiopentone at the neuromuscular junction. The evaluation of the degree of succinylcholine-induced fasciculations must take into consideration the dose of thiopentone administered at induction of anaesthesia.