To locate the binding sites of general anesthetics on ligand-gated ion channels, two derivatives of the intravenous general anesthetic etomidate (2-ethyl 1-(phenylethyl)-1H-imidazole-5-carboxylate), in which the 2-ethyl group has been replaced by photoactivable groups based on either aryl diazirine or benzophenone chemistry, have been synthesized and characterized pharmacologically. TDBzl-etomidate (4-[3-(trifluoromethyl)-3H-diazirin-3-yl]benzyl 1-(1-phenylethyl)-1H-imidazole-5-carboxylate) and BzBzl-etomidate (4-benzoylbenzyl-1-(1-phenylethyl)-1H-imidazole-5-carboxylate are both potent general anesthetics with half-effective anesthetic concentrations of 700 and 220 nM, respectively. Both agents resembled etomidate in enhancing currents elicited by low concentrations of GABA on heterologously expressed GABAA receptors and in shifting the GABA concentration-response curve to lower concentrations. They also allosterically enhanced the binding of flunitrazepam to mammalian brain GABAA receptors. Both agents were also effective and selective photolabels, photoincorporating into some, but not all, subunits of the Torpedo nicotinic acetylcholine receptor to a degree that was allosterically regulated by an agonist or a noncompetitive inhibitor. Thus, they have the necessary pharmacological and photochemical properties to be useful in identifying the site of etomidate-induced anesthesia.
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http://dx.doi.org/10.1021/jm051207b | DOI Listing |
Cureus
November 2024
Anesthesiology and Pain Medicine, Harborview Medical Center, Seattle, USA.
Prompt emergence from general anesthesia is crucial after neurosurgical procedures, such as craniotomies, to facilitate timely neurological evaluation for identification of intraoperative complications. Delayed emergence can be caused by residual anesthetics, metabolic imbalances, and intracranial pathology, for which an eye examination can provide early diagnostic clues. The sunset sign (or setting sun sign), characterized by a downward deviation of the eyes, can be an early indicator of raised intracranial pressure (ICP) or midbrain compression, as is commonly observed in states of hydrocephalus or periaqueductal or tectal plate dysfunction.
View Article and Find Full Text PDFOpen Vet J
November 2024
Department of Molecular Biotechnology, Central Laboratory Unit, University Nacional Hermilio Valdizán, Huánuco, Perú.
Background: The limited and detailed literature on total intravenous anesthesia (TIVA), as well as the clinical indications for unilateral ovariectomy in llamas, are not well-defined. Therefore, it is necessary to understand the anesthetic events and the surgical intervention in this species.
Aim: The objective of this study was to evaluate the intraoperative physiological and clinical parameters in llamas undergoing unilateral ovariectomy, under three protocols of TIVA.
SAGE Open Med Case Rep
December 2024
Department of Anesthesiology, Showa University School of Medicine, Tokyo, Japan.
Remimazolam, a short-acting benzodiazepine approved for use in general anesthesia in Japan in 2020, has cardiovascular stability superior to conventional anesthetics. Anesthesia management using remimazolam of a patient with impaired cardiac function and several complications is reported. A man in his 50s with hypertension, diabetes mellitus, and chronic kidney disease (G 5) on dialysis came to our hospital with a chief complaint of exertional dyspnea and chest tightness, and a close examination showed stenoses of three coronary arteries.
View Article and Find Full Text PDFFront Pharmacol
December 2024
Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Background: Mice play a crucial role in studying the mechanisms of general anesthesia. However, identifying reliable EEG markers for different depths of anesthesia induced by multifarious agents remains a significant challenge. Spindle activity, typically observed during NREM sleep, reflects synchronized thalamocortical activity and is characterized by a frequency range of 7-15 Hz and a duration of 0.
View Article and Find Full Text PDFBMC Anesthesiol
December 2024
Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, Hebei, China.
Objectives: To explore the effect of mild cognitive impairment (MCI) and MCI with sleep disorders on the potency of sevoflurane anesthesia in the elderly.
Design: Prospective study methods. Dixon up-and-down methods.
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