Cheng G, Kendig J J
Department of Anesthesia, Stanford University School of Medicine, Stanford, California, USA.
Anesthesiology. 2000 Oct;93(4):1075-84. doi: 10.1097/00000542-200010000-00032.
The spinal cord is an important anatomic site at which volatile agents act to prevent movement in response to a noxious stimulus. This study was designed to test the hypothesis that enflurane acts directly on motor neurons to inhibit excitatory synaptic transmission at glutamate receptors.
Whole-cell recordings were made in visually identified motor neurons in spinal cord slices from 1- to 4-day-old mice. Excitatory postsynaptic currents (EPSCs) or potentials (EPSPs) were evoked by electrical stimulation of the dorsal root entry area or dorsal horn. The EPSCs were isolated pharmacologically into glutamate N-methyl-d-aspartate (NMDA) receptor- and non-NMDA receptor-mediated components by using selective antagonists. Currents also were evoked by brief pulse pressure ejection of glutamate under various conditions of pharmacologic blockade. Enflurane was made up as a saturated stock solution and diluted in the superfusate; concentrations were measured using gas chromatography.
Excitatory postsynaptic currents and EPSPs recorded from motor neurons by stimulation in the dorsal horn were mediated by glutamate receptors of both non-NMDA and NMDA subtypes. Enflurane at a general anesthetic concentration (one minimum alveolar anesthetic concentration) reversibly depressed EPSCs and EPSPs. Enflurane also depressed glutamate-evoked currents in the presence of tetrodotoxin (300 nm), showing that its actions are postsynaptic. Block of inhibitory gamma-aminobutyric acid A and glycine receptors by bicuculline (20 micrometer) or strychnine (2 micrometer) or both did not significantly reduce the effects of enflurane on glutamate-evoked currents. Enflurane also depressed glutamate-evoked currents if the inhibitory receptors were blocked and if either D,L-2-amino-5-phosphonopentanoic acid (50 micrometer) or 6-cyano-7-nitroquinoxaline-2,3-dione disodium (10 micrometer) was applied to block NMDA or alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid-kainate receptors respectively.
Enflurane exerts direct depressant effects on both alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid and NMDA glutamate currents in motor neurons. Enhancement of gamma-aminobutyric acid A and glycine inhibition is not needed for this effect. Direct depression of glutamatergic excitatory transmission by a postsynaptic action on motor neurons thus may contribute to general anesthesia as defined by immobility in response to a noxious stimulus.
脊髓是一个重要的解剖部位,挥发性麻醉药在此发挥作用,以防止机体对有害刺激产生运动反应。本研究旨在验证异氟烷直接作用于运动神经元,抑制谷氨酸受体处兴奋性突触传递这一假说。
对1至4日龄小鼠脊髓切片中视觉识别的运动神经元进行全细胞记录。通过电刺激背根进入区或背角诱发兴奋性突触后电流(EPSC)或兴奋性突触后电位(EPSP)。使用选择性拮抗剂将EPSC药理学分离为谷氨酸N-甲基-D-天冬氨酸(NMDA)受体介导成分和非NMDA受体介导成分。在各种药理阻断条件下,通过短暂脉冲压力喷射谷氨酸也可诱发出电流。异氟烷配制成饱和储备溶液并在灌流液中稀释;使用气相色谱法测量浓度。
通过刺激背角在运动神经元记录到的兴奋性突触后电流和EPSP由非NMDA和NMDA亚型的谷氨酸受体介导。处于全身麻醉浓度(一个最低肺泡麻醉浓度)的异氟烷可逆性抑制EPSC和EPSP。在存在河豚毒素(300 nM)的情况下,异氟烷也抑制谷氨酸诱发的电流,表明其作用是突触后性的。用荷包牡丹碱(20 μM)或士的宁(2 μM)或两者阻断抑制性γ-氨基丁酸A和甘氨酸受体,并未显著降低异氟烷对谷氨酸诱发电流的影响。如果抑制性受体被阻断,并且分别应用D,L-2-氨基-5-膦酰基戊酸(50 μM)或6-氰基-7-硝基喹喔啉-2,3-二酮二钠(10 μM)阻断NMDA或α-氨基-3-羟基-5-甲基-4-异恶唑丙酸-海人藻酸受体,异氟烷也会抑制谷氨酸诱发的电流。
异氟烷对运动神经元中的α-氨基-3-羟基-5-甲基-4-异恶唑丙酸电流和NMDA谷氨酸电流均有直接抑制作用。产生这种作用不需要增强γ-氨基丁酸A和甘氨酸的抑制作用。因此,通过对运动神经元的突触后作用直接抑制谷氨酸能兴奋性传递,可能有助于实现因对有害刺激无运动反应而定义的全身麻醉。