Mitsuyo Toshihiko, Dutton Robert C, Antognini Joseph F, Carstens Earl
Department of Anesthesiology and Resuscitology, Ehime University Medical School, Matsuyama, Japan.
Anesth Analg. 2006 Sep;103(3):753-60. doi: 10.1213/01.ane.0000230605.22930.52.
Halothane and isoflurane, in the peri-minimum alveolar anesthetic concentration (MAC) range, exert differential effects on spinal nociceptive neurons, whereby halothane further depresses their responses from 0.8 to 1.2 MAC, whereas isoflurane does not. We presently investigated if these anesthetics differentially affect windup, the progressive increase in neuronal responses to repetitive noxious stimuli, over a broad concentration range from 0 to 1.2 MAC. In decerebrated rats, single-unit recordings were made from dorsal horn neurons exhibiting windup to 20 1-Hz C-fiber strength electrical stimuli. Halothane and isoflurane (0, 0.4, 0.8, and 1.2 MAC) were tested in a counterbalanced crossover protocol. Increasing halothane and isoflurane from 0 to 1.2 MAC progressively suppressed the response to the first stimulus, as well as summed responses to all stimuli (to 34% +/- 8% and 50% +/- 8%, respectively; P < 0.05). Absolute windup (summed response minus 20x the first response) was suppressed by both anesthetics from 0 to 0.8 MAC, with further depression by halothane but not isoflurane at 1.2 MAC. Responses of neurons isolated at 0 MAC were partially, but never totally, depressed at 0.8 MAC. The dose-dependent suppression of windup is consistent with reduced temporal summation of pain. Further depression at 1.2 MAC halothane, but not isoflurane, suggests different sites of immobilizing action for these two anesthetics. Immobility seems to not be mediated by severe anesthetic depression of a subpopulation of nociceptive neurons.
在最低肺泡有效浓度(MAC)范围内,氟烷和异氟烷对脊髓伤害性神经元产生不同的影响,在0.8至1.2 MAC时,氟烷会进一步抑制它们的反应,而异氟烷则不会。我们目前研究了在0至1.2 MAC的广泛浓度范围内,这些麻醉剂是否对windup(神经元对重复性伤害性刺激的反应逐渐增加)有不同影响。在去大脑的大鼠中,从对20次1赫兹C纤维强度电刺激表现出windup的背角神经元进行单单位记录。氟烷和异氟烷(0、0.4、0.8和1.2 MAC)按照平衡交叉方案进行测试。将氟烷和异氟烷从0增加到1.2 MAC会逐渐抑制对第一个刺激的反应以及对所有刺激的总和反应(分别降至34%±8%和50%±8%;P<0.05)。两种麻醉剂在0至0.8 MAC时都会抑制绝对windup(总和反应减去第一个反应的20倍),在1.2 MAC时氟烷会进一步抑制,但异氟烷不会。在0 MAC分离的神经元反应在0.8 MAC时部分但从未完全被抑制。windup的剂量依赖性抑制与疼痛的时间总和减少一致。在1.2 MAC时氟烷而非异氟烷的进一步抑制表明这两种麻醉剂的固定作用位点不同。不动似乎不是由伤害性神经元亚群的严重麻醉抑制介导的。