Brain areas modulation in consciousness during sevoflurane anesthesia

Abstract

Sevoflurane is presently one of the most used inhaled anesthetics worldwide. However, the mechanisms through which sevoflurane acts and the areas of the brain associated with changes in consciousness during anesthesia remain important and complex research questions. Sevoflurane is generally regarded as a volatile anesthetic that blindly targets neuronal (and sometimes astrocyte) GABAA receptors. This review focuses on the brain areas of sevoflurane action and their relation to changes in consciousness during anesthesia. We cover 20 years of history, from the bench to the bedside, and include perspectives on functional magnetic resonance, electroencephalogram, and pharmacological experiments. We review the interactions and neurotransmitters involved in brain circuits during sevoflurane anesthesia, improving the effectiveness and accuracy of sevoflurane’s future application and shedding light on the mechanisms behind human consciousness.

High-Performance Bidirectional Microelectrode Array for Assessing Sevoflurane Anesthesia Effects and In Situ Electrical Stimulation in Deep Brain Regions

“…Additionally, our findings affirm a robust negative correlation between the DMH and the administration of sevoflurane anesthesia, corroborating prior research. 10,14 Specifically, the spike firing rates of SI and SE neurons, in addition to the power of LFPs, have emerged as reliable electrophysiological indices capable of real-time assessment of the depth of consciousness following sevoflurane anesthesia. During the arousal phase following anesthesia, the firing patterns of neurons are highly indicative of awareness recovery.…”

“…14 There are also other neural circuits, such as suprachiasmatic nucleus (SCN)-DMH-locus coeruleus (LC), that can adjust the arousal level under sevoflurane anesthesia. 10 At the same time, deep brain stimulation (DBS) has emerged as a versatile technique capable of eliciting network responses through modulation of the stimulation frequency, with minimal side effects. 15,16 It is widely acknowledged that different frequencies of DBS can either trigger or inhibit spike generation, contingent upon the specific neuronal types and circuits involved.…”

“…The Supporting Information is available free of charge at https://pubs.acs.org/doi/10.1021/acssensors.3c02676. State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, China; School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, PR China; Email: wangmixia@mail.ie.ac.cn Ying Wang − Department of Anesthesiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China; Email: wy10879@rjh.com.cn Xinxia Cai − State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, China; School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, PR China; orcid.org/0000-0001-5997-7252; Email: xxcai@ mail.ie.ac.cn ; IrOx, iridium oxide; MEMS, microelectromechanical system; LFPs, local field potentials; PtNPs, platinum nanoparticles; EIS, electrochemical impedance spectroscopy; CV, cyclic voltammetry; CSC, charge storage capacity; C dl , doublelayer capacitance; PSDs, power spectral densities; LFS, lowfrequency stimulation; HFS, high-frequency stimulation…”

“…Recent studies have indicated that the dorsomedial hypothalamic nucleus dorsomedial hypothalamus (DMH) plays a pivotal role in the process of sevoflurane anesthesia. , Basic scientific investigations have successfully revealed molecular targets of sevoflurane, including γ-aminobutyric acid type A (GABAA) receptors and others. − Within the DMH, the orchestration of arousal is facilitated through the reception of GABAergic neurons from the ventral tegmental area and the subsequent regulation of downstream orexin targets . There are also other neural circuits, such as suprachiasmatic nucleus (SCN)-DMH-locus coeruleus (LC), that can adjust the arousal level under sevoflurane anesthesia .…”

“…Recent studies have indicated that the dorsomedial hypothalamic nucleus dorsomedial hypothalamus (DMH) plays a pivotal role in the process of sevoflurane anesthesia. , Basic scientific investigations have successfully revealed molecular targets of sevoflurane, including γ-aminobutyric acid type A (GABAA) receptors and others. − Within the DMH, the orchestration of arousal is facilitated through the reception of GABAergic neurons from the ventral tegmental area and the subsequent regulation of downstream orexin targets . There are also other neural circuits, such as suprachiasmatic nucleus (SCN)-DMH-locus coeruleus (LC), that can adjust the arousal level under sevoflurane anesthesia . At the same time, deep brain stimulation (DBS) has emerged as a versatile technique capable of eliciting network responses through modulation of the stimulation frequency, with minimal side effects. , It is widely acknowledged that different frequencies of DBS can either trigger or inhibit spike generation, contingent upon the specific neuronal types and circuits involved. , Consequently, diverse-frequency DBS within the DMH holds promise for expediting the emergence from sevoflurane anesthesia.…”