Alphaxalone, a neurosteroid anesthetic, inhibits norepinephrine transporter function in cultured bovine adrenal medullary cells

Evaluation of intravenous administration of alfaxalone, propofol, and ketamine-diazepam for anesthesia in alpacas

OBJECTIVE

To evaluate the effects of induction of anesthesia with alfaxalone in alpacas.

STUDY DESIGN

Prospective, randomized, crossover design.

ANIMALS

Five healthy alpacas (96.7 ± 19.9 kg, 9.6 ± 3.1 years old).

METHODS

The alpacas were anesthetized on three occasions with alfaxalone, propofol, or ketamine-diazepam by intravenous injection. Quality of induction and intubation was assessed using a simple descriptive scale, and quality of recovery was scored: 1 (very poor)-5 (excellent). The auricular artery was catheterized for measurement of systolic (SAP), mean (MAP), and diastolic (DAP) arterial pressures and collection of blood. Variables measured were hemoglobin oxygen saturation (SpO2 ), respiratory rate, and end-tidal carbon dioxide partial pressure (Pe'CO2 ), and ECG. Repeated measures anova was used to assess effects of drug and time. Significance was set at p < 0.05.

RESULTS

Mean dose of alfaxalone sufficient to allow intubation was 2.1 mg kg(-1) . Induction was excellent with all protocols. Heart rate (HR), SAP and MAP were significantly higher following alfaxalone compared to ketamine-diazepam. Blood lactate concentration when standing following alfaxalone was higher compared to minutes 1 and 6, and to propofol (p < 0.05). All alpacas required oxygen supplementation and mechanical ventilation to treat SpO2  < 90% or Pe'CO2  > 60 mmHg. Time from induction to standing was longer with alfaxalone (34.1 ± 3.2 minutes) than propofol (19.0 ±4.3 minutes) or ketamine-diazepam (24.9 ±1.7 minutes). Recovery quality median scores were clinically and statistically different: 2 (alfaxalone), 4 (ketamine-diazepam), and 5 (propofol). Tremors, paddling, rolling, seizure-like activity and thrashing characterized recovery from alfaxalone.

CONCLUSION

Recovery quality was worst with alfaxalone. HR, SAP, MAP were increased at minute 1 in all protocols. Transient hypercapnia and hypoxia was observed with all protocols.

CLINICAL RELEVANCE

All protocols were adequate for induction of anesthesia. Alfaxalone alone in unpremedicated alpacas is not recommended.

The inhibitory effects of alphaxalone on M1 and M3 muscarinic receptors expressed in Xenopus oocytes

Alphaxalone is a neurosteroid anesthetic, but its mechanisms of action are not completely understood. Muscarinic receptors are involved in a variety of neuronal functions in the brain and autonomic nervous system, and much attention has been paid to them as targets of anesthetics. In this study, we investigated the effects of alphaxalone on M(1) and M(3) muscarinic receptors using the Xenopus oocyte expression system. Alphaxalone inhibited acetylcholine-induced currents in oocytes expressing M(1) receptors at clinically relevant concentrations. Alphaxalone also suppressed acetylcholine-induced currents in oocytes expressing M(3) receptors. The half-maximal inhibitory concentration values for the inhibition of M(1)- and M(3)-mediated currents were 1.8 +/- 0.6 micro M and 5.3 +/- 1.0 micro M, respectively. GF109203X, a selective protein kinase C inhibitor, had little effect on the inhibition of acetylcholine-induced currents by alphaxalone in oocytes expressing these receptors. Alphaxalone inhibited the specific binding of [(3)H]quinuclidinyl benzilate to oocytes expressing M(1) or M(3) receptors. These findings suggest that alphaxalone at clinically relevant concentrations inhibits the function of M(1) and M(3) receptors through a protein kinase C-independent mechanism by interfering with the [(3)H]quinuclidinyl benzilate binding sites on the receptors.

IMPLICATIONS

Alphaxalone, a neurosteroid anesthetic, inhibited the function of muscarinic M(1) and M(3) receptors and the specific binding of [(3)H]quinuclidinyl benzilate ([(3)H]QNB) to oocytes expressing these receptors. These findings suggest that alphaxalone inhibits these receptors by interfering with the QNB binding sites.