Background: How volatile anesthetics work remains poorly understood. Modulations of synaptic neurotransmission are the direct cellular mechanisms of volatile anesthetics in the central nervous system. Volatile anesthetics such as isoflurane may reduce neuronal interaction by differentially inhibiting neurotransmission between GABAergic and glutamatergic synapses. Presynaptic voltage-dependent sodium channels (Na), which are strictly coupled with synaptic vesicle exocytosis, are inhibited by volatile anesthetics and may contribute to the selectivity of isoflurane between GABAergic and glutamatergic synapses. However, it is still unknown how isoflurane at clinical concentrations differentially modulates Na currents between excitatory and inhibitory neurons at the tissue level.
Methods: In this study, an electrophysiological recording was applied in cortex slices to investigate the effects of isoflurane on Na between parvalbumin (PV) and pyramidal neurons in PV-cre-tdTomato and/or vglut2-cre-tdTomato mice.
Results: Isoflurane at clinically relevant concentrations produced a hyperpolarizing shift in the voltage-dependent inactivation and slowed the recovery time from the fast inactivation in both cellular subtypes. Since the voltage of half-maximal inactivation was significantly depolarized in PV neurons compared to that of pyramidal neurons, isoflurane inhibited the peak Na currents in pyramidal neurons more potently than those of PV neurons (35.95 ± 13.32% vs. 19.24 ± 16.04%, = 0.036 by the Mann-Whitney test).
Conclusions: Isoflurane differentially inhibits Na currents between pyramidal and PV neurons in the prefrontal cortex, which may contribute to the preferential suppression of glutamate release over GABA release, resulting in the net depression of excitatory-inhibitory circuits in the prefrontal cortex.
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http://dx.doi.org/10.3389/fncir.2023.1185095 | DOI Listing |
NeuroSci
December 2024
Department of Palliative Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland.
Background: Intraoperative neuromonitoring (IONM) is crucial for the safety of scoliosis surgery, providing real-time feedback on the spinal cord and nerve function, primarily through motor-evoked potentials (MEPs). The choice of anesthesia plays a crucial role in influencing the quality and reliability of these neuromonitoring signals. This systematic review evaluates how different anesthetic techniques-total intravenous anesthesia (TIVA), volatile anesthetics, and regional anesthesia approaches such as Erector Spinae Plane Block (ESPB), spinal, and epidural anesthesia-affect IONM during scoliosis surgery.
View Article and Find Full Text PDFRev Esp Anestesiol Reanim (Engl Ed)
December 2024
Department of Anesthesiology, Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia.
Background: The healthcare sector emits 5% of greenhouse gases worldwide, inhaled anaesthetic agents have contributed to this effect for years. Other countries measured and limited their use, leading to positive environmental changes. There is a lack of data on Colombia.
View Article and Find Full Text PDFFEBS Open Bio
December 2024
Department of Cell Physiology, Institute of Biomedical Science, Kansai Medical University, Hirakata, Osaka, Japan.
Proper glycemic control is crucial for patient management in critical care, including perioperative care, and can influence patient prognosis. Blood glucose concentration determines insulin secretion and sensitivity and affects the intricate balance between the glucose metabolism. Human and other animal studies have demonstrated that perioperative drugs, including volatile anesthetics and intravenous anesthetics, affect glucose-stimulated insulin secretion (GSIS).
View Article and Find Full Text PDFPain Physician
December 2024
Department of Anesthesiology, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ.
Background: Poorly controlled acute breast surgery postoperative pain is associated with delayed recovery, increased morbidity, impaired quality of life, and prolonged opioid use during and after hospitalization. Recently, ultrasound-guided pectoralis nerve (PECS) I block and serratus anterior plane (SAP) block, together or individually, have emerged as a potential method to relieve pain, decrease opioid requirements, and improve patient outcomes.
Objective: The aim of this study was to assess if the addition of a PECS I/SAP block in patients undergoing bilateral mastectomies provides more effective perioperative analgesia compared to standard analgesia.
Can J Anaesth
December 2024
Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
Purpose: This Continuing Professional Development module aims to help the general anesthesiologist recognize common pitfalls in ambulatory pediatric adenotonsillectomy and perform appropriate risk stratification, analgesic management, and disposition planning.
Principal Findings: Pediatric adenotonsillectomy is a widely performed procedure. An updated approach to preoperative risk assessment of commonly associated comorbidities allows the practitioner to anticipate and plan for adverse events.
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