Modulation of NMDA Receptor Function by Ketamine and Magnesium. Part II: Interactions with Volatile Anesthetics

Hollmann, Markus W.; Liu, Hongtao; Hoenemann, Christian W.; Liu, Weihua; Durieux, Marcel E.

doi:10.1097/00000539-200105000-00020

Cited by 140 publications

(102 citation statements)

References 24 publications

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“…9 Moreover, several in vitro electrophysiological and pharmacological studies have demonstrated sevoflurane's anti-NMDA properties. 21,23 The findings from our study suggest that sevoflurane, when administered at concentrations even below the MAC value, might play an anti-hyperalgesic role via an anti-NMDA action.…”

Section: Discussionmentioning

confidence: 71%

“…8,[18][19][20] Halogenated anesthetics have in vitro anti-NMDA properties. [21][22][23][24] Other studies have shown that halogenated anesthetics induce hyperalgesia when administered at very low concentrations 25,26 and even decrease morphine analgesic effects. 25,27 However, in the context of current clinical practice, it is unresolved as to whether or not inhaled anesthetics elicit residual effects on postoperative hyperalgesia.…”

Section: Résumémentioning

confidence: 99%

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Effects of sevoflurane on carrageenan- and fentanyl-induced pain hypersensitivity in Sprague-Dawley rats

Richebé

Rivalan

Rivat

et al. 2008

Can J Anesth/J Can Anesth

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Purpose Opioids are widely used for anesthesia but paradoxically induce postoperative pain hypersensitivity via N-methyl-D-aspartate (NMDA) receptor modulation. Sevoflurane effects on opioid-induced hyperalgesia have not been yet evaluated in vivo. Nevertheless, some experimental in vitro studies reported anti-NMDA receptor properties for sevoflurane. The aim of this study was to evaluate sevoflurane effects on fentanyl-induced hyperalgesia in opioid-naive rats and in rats with inflammatory pain. Methods Sevoflurane effects on hyperalgesia were evaluated in Sprague-Dawley rats: opioid-naive rats, rats treated with fentanyl (4 9 60 lg kg -1 ) and rats with inflammatory pain (carrageenan) treated with fentanyl (4 9 60 lg kg -1 ). On day zero, subcutaneous fentanyl injections were administered and inflammatory pain was induced with one carrageenan injection in one hind paw. Rats were exposed to low concentrations of sevoflurane (1.0 or 1.5%) on day zero prior to fentanyl injections and inflammatory pain induction, and for the duration of the fentanyl analgesic effect. The nociceptive threshold (Randall-Selitto test) was evaluated daily for 7 days. On day seven, naloxone was injected and the nociceptive threshold was assessed 5 min later. Results In rats without inflammatory pain but treated with fentanyl on day zero, sevoflurane 1.0% reversed the early (day zero) and long-lasting (day zero to day three) hyperalgesia classically described after high-doses of fentanyl (P \ 0.05). This sevoflurane concentration antagonized the hyperalgesia induced by naloxone on day seven (P = 0.33). In a second experiment in rats with inflammatory pain, exposure to low concentrations of sevoflurane (1.0 and 1.5%) did not reduce fentanyl-induced hyperalgesia (P [ 0.05), but nevertheless antagonized the naloxone induced hyperalgesia on day seven (P = 0.061). Conclusion Relatively low sevoflurane concentrations (1.0%) reverse fentanyl-induced hyperalgesia in rats without inflammatory pain. Nevertheless, the lack of effect of sevoflurane concentrations of 1.0% and 1.5% to oppose hyperalgesia following high-dose fentanyl and inflammatory pain suggests that sevoflurane anti-hyperalgesic properties are weak. RésuméObjectif Les opioı¨des sont largement utilise´s en anesthe´sie mais induisent paradoxalement une hypersensibiliteṕ ostope´ratoire a`la douleur via une modulation des re´cepteurs N-me´thyl-D-aspartate (NMDA). Les effets du

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Section: Discussionmentioning

confidence: 71%

Section: Résumémentioning

confidence: 99%

Effects of sevoflurane on carrageenan- and fentanyl-induced pain hypersensitivity in Sprague-Dawley rats

Richebé

Rivalan

Rivat

et al. 2008

Can J Anesth/J Can Anesth

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“…This may explain lower effectiveness of pethidine in opioid-dependent patients compare to normal population. Ketamine has also effect on modulation of NMDA receptor function to decrease tolerance to opioids in opioid-dependent patients (Hollmann, Liu, Hoenemann, Liu, & Durieux, 2001). However, ketamine effect on postoperative shivering is not far more than clonidine or Pethidine in opioid-dependent patients.…”

Section: Resultsmentioning

confidence: 99%

Effect of Preemptive Clonidnine Versus Pethidine and Ketamine on Postoperative Shivering During Spinal Anesthesia

Ghasemi¹,

Behnaz²,

Mad³

2017

JMBR

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Introduction: Postoperative Shivering is an early postoperative complication. Incidence of postoperative shivering (POS) following surgeries varies between 20 to 60%. There is still no consensus on treatment modalities especially in opioid-dependent patients. Aim: To compare the effect of preemptive clonidine, ketamin and pethidine in controlling postoperative shivering in addicted patients who undergo spinal anesthesia. Methods: In a clinical trial, 81 patients who underwent spinal anesthesia for elective orthopaedic surgery for lower limb were enrolled and assigned to groups of 27 patients of the study based on accidental numbers, and 2 patients in Pethidine group and 2 patients in ketamine group were excluded from the study. Clonidine 2 mg was administered orally prior to surgery. Ketamin 2mg/kg and pethidine 0.5 mg/kg were administered in recovery to the patients. Postoperative shivering was measured in patients during stay in post anethesia care unit. Blood pressure and heart rate was recorded during 30 minutes after spinal anethesia in operating room. Results: No significant differences in blood pressure and heart rate were observed between patients. Incidence of postoperative shivering was 28% in clonidine, 36% in pethidine and 48% in ketamin group. Risk of shivering was significantly reduced in patients received clonidine in compare to ketamine (RR: 0.34, 95% CI: 0.138-0.856, p=0.022) which was significant and compare to pethidine (RR=0.79, 95% CI: 0.272-2.323, p=0.67) which was not significant. Conclusion: preemptive Clonidine has superior effect compare to postoperative ketamin and pethidine in controlling postoperative shivering.

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“…(5) Bu amaçla, NMDA reseptör antagonizması yoluyla SSS'de depresyon yaparak anestezik etkinlik gösteren magnezyum sülfat, son yıllarda genel anestezi uygulamalarında adjuvan olarak kullanıl-maya başlanmıştır. (1) Magnezyumun in vitro şartlarda adrenerjik sinir uçları ve adrenal bezlerden katekolamin salınımını inhibe etmesi, insanlarda da katekolamin salınımını inhibe edebileceğini düşündürmüştür. James ve ark.…”

Section: Discussionunclassified

The Usage of Magnesium Sulphate During Induction and Maintenance of General Anesthesia

Canturk¹,

Turgut²,

Altan³

et al. 2011

J Turk Anaesth Int Care

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ÖZETAmaç: Çalışmamızda; tiroid cerrahisi planlanan hastalarda anestezi indüksiyonu ve devamında MgSO 4 kullanılması-nın anestezik ajan gereksinimi, kas gevşetici tüketimi, peroperatif hemodinami, postoperatif derlenme ve postoperatif analjezi üzerine etkilerini araştırmayı amaçladık. Bulgular: Entübasyon sonrası ve intraoperatif 15. dk. ortalama arter basınçları, kalp atım hızı Grup K'da daha yüksek saptandı. İndüksiyonda gereken propofol miktarı ve idamedeki % Fi sevofluran, rokuronyum tüketimi Grup M'de daha azdı. T1 % 10 yanıtı ve T1 % 25 yanıt süreleri Grup M'de daha geç gerçekleşti. Ekstübasyon, verbal uyarılara yanıt, sözel yanıt, Aldrete Skoru 10 olma zamanı Grup M'de daha uzun bulundu. Grup M'de VAS değerleri 10. dk., 20. dk. ve 30. dk.'larda daha düşük bulundu ve ilk analjezik gereksinim zamanı daha uzun sürede gerçekleşti.Sonuç: Perioperatif MgSO 4 kullanılması; entübasyona hemodinamik yanıtı, anestezi indüksiyonu ve anestezi uygulamasının sürdürülmesinde anestezik madde gereksinimini azaltmakta, rokuronyumun etkisini potansiyalize etmekte ve postoperative ağrı kontrolüne olumlu etki göstermektedir.Anahtar kelimeler: Magnezyum sülfat, tiroid, rokuronyum SUMMARY The Usage of Magnesium Sulphate During Induction and Maintenance of General AnesthesiaAim: We aimed to investigate the effects of MgSO 4 used during induction and maintenance of general anesthesia on anesthetic drug requirement, consumption of muscle relaxants, preoperative hemodynamics, postoperative recovery, and postoperative analgesia in patients scheduled for thyroid surgery.Material and Methods: Fifty patients (ASA I-II) were randomly allocated into two groups; Group M received 30 mg kg -1 MgSO 4 15 minutes before induction followed by 15 mg kg -1 h -1 MgSO 4 infusion, and Group K 0.9 % NaCI. Anesthesia was induced with intravenous administration of 20 mg propofol, 1 µg fentanyl and 0.6 mg kg -1 rocuronium every 5 seconds keeping BIS at 60. 1 mg kg -1 i.v. for the maintenance of anesthesia sevoflurane was used so as to keep BIS between 50, and 60. Tramadol (1 mg kg -1 iv) was used for postoperative analgesia. Postoperative analgesia level was recorded at 10., 20., 30. min and 1., 2., 3., 6. h using Visual Analogue Scale (VAS), and 75 mg diclofenac sodium iv. was administered to patients with a score of 5 or higher. Kolmogorov-Smirnov, Student's t, Man-Whitney U and Chi-square test were used for statistical analysis.Results: Postintubation and intraoperative 15. minute MAP and HR values were significantly higher in Group K patients. Propofol requirement at induction, and FI % for sevoflurane, at maintenance and total rocuronium consumption were significantly lower in Group M. T1 10 % and T1 25 % response times were delayed in Group M. Extubation time, response to verbal stimuli, verbal response time, and time to reach a score of 10 modified Aldrete score of 10 were found to be prolonged in Group M. In Group M, 10., 20., 30. min VAS scores were lower, and time to the first requirement for an analgesic was also delayed.Conclusion: Peroperativ...

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Modulation of NMDA Receptor Function by Ketamine and Magnesium. Part II: Interactions with Volatile Anesthetics

Cited by 140 publications

References 24 publications

Effects of sevoflurane on carrageenan- and fentanyl-induced pain hypersensitivity in Sprague-Dawley rats

Effects of sevoflurane on carrageenan- and fentanyl-induced pain hypersensitivity in Sprague-Dawley rats

Effect of Preemptive Clonidnine Versus Pethidine and Ketamine on Postoperative Shivering During Spinal Anesthesia

The Usage of Magnesium Sulphate During Induction and Maintenance of General Anesthesia

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