Newer concepts of analgesia and anesthesia

Intracerebroventricular (ICV) administration of the peptidase inhibitors amastatin, trasylol, bacitracin, or phe-D-ala and systemic administration of phenylmethylsulfonyl fluoride resulted in one or more of the following responses: analgesia, reduced withdrawal severity in opiate tolerant rats, alterations in motor activity and behavior, hypo- and hyperthermia and others; some of these effects were antagonized by naloxone, suggesting participation of opioid and other endogenous peptides. In addition, peptidase inhibitors enhanced analgesic and other responses to opioid peptides given ICV. Peptidase inhibition affords another method of inducing selective pharmacological responses such as pain relief in individuals resistant to other forms of therapy. ICV administration of beta-endorphin in the rat induces general anesthesia that is instantly reversed by systemic naloxone. Extensions of this work include identification of specific neural pathways that mediate anesthesia and characterization of opiate receptor subtype(s) at these sensitive loci. This approach offers the potential for the design of systemically effective opioid peptide anesthetics with little or no secondary effects and rapid reversibility.