The potential for safer anaesthesia using stereoselective anaesthetics.
The molecular mechanisms by which inhalational agents produce anaesthesia remains a subject of controversy, despite a history of clinical use spanning two centuries. The demonstration of a significant difference in the anaesthetic potencies of (+)- and (-)-isoflurane provides compelling evidence for the hypothesis that proteins, rather than lipids, are the primary sites of anaesthetic action. Moreover, the optically active isomers of volatile anaesthetics provide new tools to discriminate among putative molecular targets of anaesthesia. A difference in the anaesthetic potencies of (+)- and (-)-isoflurane, together with an apparent lack of stereoselectivity in their myocardial suppression, raises the possibility that an optically active volatile agent may have clinical advantages over currently available racemic mixtures.
Moody
E J
EJ
Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University, Baltimore MD 21287.
Harris
B D
BD
Skolnick
P
P
D000769:Anesthesia, Inhalation; D000818:Animals; D006801:Humans; D007530:Isoflurane / Q000494:pharmacology*; D009118:Muscimol / Q000494:pharmacology; D018079:Receptors, GABA / Q000187:drug effects / Q000378:metabolism; D012449:Safety; D013237:Stereoisomerism; D013329:Structure-Activity Relationship
D018079:Receptors, GABA; D009118:Muscimol; D007530:Isoflurane