Roy R C, Stullken E H
Anesthesiology. 1981 Oct;55(4):392-7. doi: 10.1097/00000542-198110000-00010.
The clinical impressions of enhanced arousal from halothane anesthesia and improvement of postanesthesia recovery scores after doxapram, physostigmine, or naloxone have not been verified in laboratory studies based on the effect of these drugs on MAC. With induction of anesthesia, a shift in the amplitude of the EEG from low to high occurs at anesthetic concentrations well below MAC and appears to coincide with the loss of consciousness. The authors examined the effect of arousal agents on the end-tidal halothane concentration required to produce this shifting EEG. In 24 unmedicated dogs, the end-tidal halothane concentration was elevated to 20 per cent above the shift point concentration (from 0.61 +/- 0.03 to 0.73 +/- 0.03 per cent) and maintained at this level for 30 min. Doxapram, 1 mg/kg, iv, and physostigmine, 0.03 mg/kg, iv, converted the EEG from a high amplitude to a low amplitude tracing in 22 +/- 3 s in eight of eight, and 225 +/- 37 s in seven of eight dogs, respectively. The end-tidal halothane concentration required to restore the shifting EEG was elevated above control for 50 +/- 7 min and 109 +/- 7 min, respectively. Naloxone, 0.06 mg/kg, iv, produced an awake EEG in two of eight dogs in 233 +/- 18 s which persisted for 22 +/- 4 min, and a transiently shifting EEG in three of eight dogs between 200 and 240 s. Naloxone 0.006, mg/kv, iv, produced an awake EEG in 80 +/- 8 s in four of four dogs who had previously received doxapram 3 h earlier. In this model doxapram and physostigmine paralleled the clinically observed onset and duration of arousal. The inconstant arousal from halothane anesthesia induced by naloxone was interpreted in terms of an opiate receptor independent action.
氟烷麻醉后兴奋增强以及多沙普仑、毒扁豆碱或纳洛酮应用后麻醉恢复评分改善的临床印象,在基于这些药物对最低肺泡有效浓度(MAC)影响的实验室研究中尚未得到证实。随着麻醉诱导,脑电图(EEG)振幅在远低于MAC的麻醉浓度下从低向高转变,且似乎与意识丧失同时发生。作者研究了兴奋药对产生这种EEG转变所需的呼气末氟烷浓度的影响。在24只未用药的犬中,呼气末氟烷浓度升高至高于转变点浓度20%(从0.61±0.03%升至0.73±0.03%)并维持此水平30分钟。静脉注射1mg/kg多沙普仑和0.03mg/kg毒扁豆碱后,分别在8只犬中的8只、8只犬中的7只于22±3秒和225±37秒内使EEG从高振幅转变为低振幅描记。恢复EEG转变所需的呼气末氟烷浓度分别高于对照50±7分钟和109±7分钟。静脉注射0.06mg/kg纳洛酮后,8只犬中的2只在233±18秒内出现清醒EEG并持续22±4分钟,8只犬中的3只在200至240秒之间出现短暂的EEG转变。静脉注射0.006mg/kg纳洛酮后,4只先前在3小时前接受过多沙普仑的犬中的4只在80±8秒内出现清醒EEG。在该模型中,多沙普仑和毒扁豆碱与临床上观察到的兴奋起效和持续时间相似。纳洛酮诱导的氟烷麻醉后兴奋不恒定,被解释为与阿片受体无关的作用。