Inhaled anesthetics and immobility: mechanisms, mysteries, and minimum alveolar anesthetic concentration.
Studies using molecular modeling, genetic engineering, neurophysiology/pharmacology, and whole animals have advanced our understanding of where and how inhaled anesthetics act to produce immobility (minimum alveolar anesthetic concentration; MAC) by actions on the spinal cord. Numerous ligand- and voltage-gated channels might plausibly mediate MAC, and specific amino acid sites in certain receptors present likely candidates for mediation. However, in vivo studies to date suggest that several channels or receptors may not be mediators (e.g., gamma-aminobutyric acid A, acetylcholine, potassium, 5-hydroxytryptamine-3, opioids, and alpha(2)-adrenergic), whereas other receptors/channels (e.g., glycine, N-methyl-D-aspartate, and sodium) remain credible candidates.
Sonner
James M
JM
*Department of Anesthesia and Perioperative Care, University of California, San Francisco, California; †Department of Anesthesiology, University of California, Davis, California; ‡Columbia University, New York, New York; §University of Texas, Austin, Texas; ∥University of Pittsburgh, Pittsburgh, Pennsylvania; ¶Stanford University, Palo Alto, California; #University of Toronto, Toronto, Canada; **Department of Anaesthesia, Harvard Medical School, Cambridge, Massachusetts; and ††Garvan Institute of Medical Research, Darlinghurst, Australia.
Antognini
Joseph F
JF
Dutton
Robert C
RC
Flood
Pamela
P
Gray
Andrew T
AT
Harris
R Adron
RA
Homanics
Gregg E
GE
Kendig
Joan
J
Orser
Beverley
B
Raines
Douglas E
DE
Trudell
James
J
Vissel
Bryce
B
Eger
Edmond I
EI
D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D000818:Animals; D005818:Genetic Engineering; D006801:Humans; D066298:In Vitro Techniques; D007473:Ion Channels / Q000187:drug effects; D008958:Models, Molecular; D009068:Movement / Q000187:drug effects*; D011650:Pulmonary Alveoli / Q000378:metabolism*; D013116:Spinal Cord / Q000187:drug effects / Q000502:physiology
D018685:Anesthetics, Inhalation; D007473:Ion Channels