From the Neuroanesthesia Laboratory, Atlanta VA Medical Center, Emory University, Atlanta, Georgia.
Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia.
Anesth Analg. 2021 May 1;132(5):1347-1358. doi: 10.1213/ANE.0000000000005379.
Attaining a rapid and smooth return to consciousness after general anesthesia is a goal for clinical anesthesiologists. This study aimed to investigate the effects of repeated anodal transcranial direct current stimulation (atDCS) on emergence and recovery from isoflurane anesthesia in rats.
Four days after surgery for atDCS socket implantation, rats received either sham stimulation or repetitive anodal direct electrical current of 0.2 mA intensity applied to the right motor cortex for 20 minutes/d for 10 consecutive days. Isoflurane potency and emergence and recovery from a 2-hour isoflurane challenge were evaluated 24 hours after the last atDCS session. Cognitive performance on novel object recognition and spontaneous alternation Y-maze tests were measured 48 hours after the last atDCS session. Locomotor activity was assessed via automated counting of electric infrared beam crossings.
Data are expressed as mean ± standard error of mean (SEM). Isoflurane potency was not affected by atDCS (sham: 1.69% ± 0.06%, transcranial direct current stimulation [tDCS]: 1.73% ± 0.11%, mean difference [MD]: 0.045, 95% confidence interval [CI]: -0.22 to 0.30; P = .72). However, the time to appearance of emergence behavioral marker (eg, return of righting reflex) was hastened in rats receiving atDCS (sham: 486 ± 31 seconds, tDCS: 330 ± 45 seconds, MD: 157, 95% CI: 30-284; P = .008). Similarly, time to acknowledgment of adhesive tape ("sticky dot" applied while anesthetized) was also decreased in atDCS-treated rats as compared to sham (sham: 1374 ± 179 seconds, tDCS: 908 ± 151 seconds, MD: 466, 95% CI: 73-858; P = .015), indicating a faster recovery of isoflurane anesthesia. Rats treated with atDCS spent more time exploring the novel object and environment when compared to sham without affecting activity cycles, indicating visual and working memory can be enhanced by atDCS.
Taken together, our findings suggest that atDCS over cortical areas might hasten recovery from isoflurane anesthesia and could potentially be used as a preventative strategy for disruptions in higher order functions related to sedation/anesthesia.
临床麻醉师的目标是在全身麻醉后迅速、平稳地恢复意识。本研究旨在探讨重复经颅直流电刺激（atDCS）对异氟烷麻醉苏醒和恢复的影响。
在接受 atDCS 插座植入手术后的第 4 天，大鼠接受假刺激或重复阳极直流电，强度为 0.2 mA，每天 20 分钟，连续 10 天。在最后一次 atDCS 治疗后 24 小时评估异氟烷效力以及从 2 小时异氟烷挑战中苏醒和恢复的情况。在最后一次 atDCS 治疗后 48 小时，通过新颖物体识别和自发交替 Y 迷宫测试评估认知表现。通过自动计数电动红外光束交叉来评估运动活动。
数据表示为平均值±标准误差（SEM）。atDCS 对异氟烷效力没有影响（假刺激：1.69%±0.06%，经颅直流电刺激（tDCS）：1.73%±0.11%，平均差异（MD）：0.045，95%置信区间（CI）：-0.22 至 0.30；P=.72）。然而，接受 atDCS 的大鼠出现苏醒行为标志物（例如，翻正反射恢复）的时间加快（假刺激：486±31 秒，tDCS：330±45 秒，MD：157，95%CI：30-284；P=.008）。同样，与假刺激相比，atDCS 治疗的大鼠在承认粘性胶带（麻醉时应用的“粘性点”）时的时间也减少（假刺激：1374±179 秒，tDCS：908±151 秒，MD：466，95%CI：73-858；P=.015），表明异氟烷麻醉的恢复更快。与假刺激相比，接受 atDCS 治疗的大鼠在探索新物体和环境时花费更多的时间，而不影响活动周期，这表明视觉和工作记忆可以通过 atDCS 增强。
综上所述，我们的研究结果表明，皮质区域的 atDCS 可能会加速异氟烷麻醉的恢复，并且可能作为预防与镇静/麻醉相关的高级功能障碍的策略。
