Department of Anesthesia, McGill University, Montreal Neurological Hospital Room 548, 3801 University St, Montreal, QC, Canada, H3A 2B4.
Br J Anaesth. 2017 Dec 1;119(6):1150-1160. doi: 10.1093/bja/aex329.
Gamma (30-80 Hz) and high-gamma (80-200 Hz) thalamocortical EEG rhythms are involved in conscious processes and are attenuated by isoflurane and propofol. To explore the hypothesis that this attenuation is a correlate of anaesthetic action, we characterized the effect dexmedetomidine, a selective adrenergic α-2 agonist with lesser hypnotic potency, on these rhythms.
We recorded local field potentials from barrel cortex and ventroposteromedial thalamic nucleus in ten previously instrumented rats to measure spectral power (30-50 Hz, 51-75 Hz, 76-125 Hz, 126-200 Hz bands) during baseline, at four dexmedetomidine plasma concentrations obtained by i.v. target-controlled infusion (1.86, 3.75, 5.63 and 7.50 ng ml -1 ), and during recovery. Thalamocortical coherence over 0.3-200 Hz was also measured.
Loss of righting reflex (LORR) occurred with 5.63 ng ml -1 . Dexmedetomidine produced a linear concentration-dependent attenuation of cortical ( P <0.04) and thalamic ( P ≤ 0.0051) log power in all bands. Slopes for cortex and thalamus were similar. The slope for dexmedetomidine on thalamic power in the 76-200 Hz range was less than half that of the other agents ( P <0.003). LORR was associated with an increase in delta band (0.3-4.0 Hz) thalamocortical coherence ( P <0.001). Increased low-frequency coherence also occurred with propofol and isoflurane.
Dexmedetomidine attenuates high-frequency thalamocortical rhythms, but to a lesser degree than isoflurane and propofol. The main differences between dexmedetomidine and the other anaesthetics involved thalamic rhythms, further substantiating the link between impaired thalamic function and anaesthesia. Increased delta coherence likely reflects cyclic hyperpolarization of thalamocortical networks and may be a marker for loss of consciousness.
伽马(30-80 Hz)和高伽马(80-200 Hz)丘脑皮层 EEG 节律参与意识过程,并被异氟醚和丙泊酚抑制。为了探索这种抑制作用是麻醉作用的相关因素的假说,我们描述了选择性肾上腺素能 α-2 激动剂右美托咪定的作用,它的催眠作用较小。
我们记录了十只先前仪器化大鼠的桶状皮层和腹后内侧丘脑核的局部场电位,以在基线期间、通过静脉内靶控输注获得的四个右美托咪定血浆浓度(1.86、3.75、5.63 和 7.50 ng ml -1 )以及恢复期间测量光谱功率(30-50 Hz、51-75 Hz、76-125 Hz、126-200 Hz 频段)。还测量了 0.3-200 Hz 的丘脑皮层相干性。
失去翻正反射(LORR)发生在 5.63 ng ml -1 。右美托咪定产生皮质(P <0.04)和丘脑(P ≤ 0.0051)对数功率的线性浓度依赖性衰减。皮层和丘脑的斜率相似。在 76-200 Hz 范围内,右美托咪定对丘脑功率的斜率小于其他药物的一半(P <0.003)。LORR 与 delta 频段(0.3-4.0 Hz)丘脑皮层相干性增加有关(P <0.001)。与异丙酚和异氟醚一样,低频相干性也增加了。
右美托咪定抑制高频丘脑皮层节律,但程度低于异氟醚和丙泊酚。右美托咪定与其他麻醉剂之间的主要区别涉及丘脑节律,进一步证实了丘脑功能障碍与麻醉之间的联系。增加的 delta 相干性可能反映了丘脑皮层网络的周期性超极化,并且可能是意识丧失的标志物。