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Related Concept Videos

Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
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General Anesthesia: Overview01:24

General Anesthesia: Overview

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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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Local Anesthetics: Mechanism of Action01:23

Local Anesthetics: Mechanism of Action

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Local anesthetics (LAs) block sensory and motor impulses by inhibiting the sodium channels on the nerve cell membranes. This induces temporary loss of sensation, relieving pain in a specific body area.
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...
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Stages of General Anesthesia01:22

Stages of General Anesthesia

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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain
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Inflammation Increases Neuronal Sensitivity to General Anesthetics.

Sinziana Avramescu1, Dian-Shi Wang, Irene Lecker

  • 1From the Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (S.A., B.A.O.); and Departments of Anesthesia (S.A., B.A.O.), Physiology (D.-S.W., I.L., W.T.H.T., A.P., R.L.H., B.A.O.), Psychology (P.D.W.), and Medicine (L.M.-O., R.L.H.), University of Toronto, Toronto, Ontario, Canada.

Anesthesiology
|November 14, 2015
PubMed
Summary

Inflammation enhances sensitivity to general anesthetics by increasing gamma-aminobutyric acid type A (GABAA) receptor activity. This study demonstrates how inflammation affects anesthetic response in neurons and behavior.

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Area of Science:

  • Neuroscience
  • Anesthesiology
  • Immunology

Background:

  • Critically ill patients with severe inflammation show increased sensitivity to general anesthetics.
  • The mechanisms underlying this heightened sensitivity are not well understood.
  • Inflammation may up-regulate gamma-aminobutyric acid type A (GABAA) receptor activity, increasing anesthetic sensitivity.

Purpose of the Study:

  • To investigate the impact of inflammation on neuronal sensitivity to general anesthetics.
  • To examine the role of gamma-aminobutyric acid type A (GABAA) receptors in inflammation-induced anesthetic hypersensitivity.

Main Methods:

  • Neurons were pretreated with interleukin (IL)-1β in vitro to mimic inflammation.
  • Whole-cell patch clamp electrophysiology recorded currents evoked by gamma-aminobutyric acid (GABA) with etomidate or isoflurane.
  • Mice were treated with lipopolysaccharide in vivo to assess anesthetic-related behavioral endpoints.

Main Results:

  • Interleukin (IL)-1β increased gamma-aminobutyric acid (GABA)-evoked currents in the presence of etomidate or isoflurane.
  • Inflammation (IL-1β or lipopolysaccharide) enhanced the hypnotic effects of etomidate and isoflurane.
  • Lipopolysaccharide increased etomidate's immobilizing properties and impaired contextual fear memory with etomidate.

Conclusions:

  • Inflammation increases neuronal sensitivity to general anesthetics.
  • This heightened sensitivity is linked to increased gamma-aminobutyric acid type A (GABAA) receptor activity.
  • Findings provide proof-of-concept for inflammation-mediated anesthetic hypersensitivity.