Exogenous adenosine potentiates hypnosis induced by intravenous anaesthetics

Abstract

SummaryWe have evaluated the effects of the volume and speed of administration of local anaesthetic during peribulbar anaesthesia. One hundred and forty patients scheduled for cataract surgery were randomly allocated to one of four groups of 35. Each patient received an injection of the same mixture of lignocaine, bupivacaine and hyaluronidase. Patients in group A were given 9 ml at a speed of 5 ml.min À1 , group B were given the same volume at 12 ml.min À1 , group C were given 13.5 ml at 5 ml.min À1 and group D were given 13.5 ml at 12 ml.min À1 . A significantly higher incidence of satisfactory akinesia was found in group D, whose pain score at injection was no higher than for the other groups. Large volumes of local anaesthetic significantly affected intraocular pressure. The incidences of early and late ptosis or diplopia were not affected by either the rate of injection or the volume of local anaesthetic.

Sleep, Anesthesiology, and the Neurobiology of Arousal State Control

“…28,30 Muscarinic receptors of the M1 subtype are located throughout the cortex. 347 The acetylcholine release data are consistent with electrophysiologic evidence showing that adenosine A 1 receptors cause presynaptic disfacilitation 348 and postsynaptic inhibition 349 of cholinergic LDT/PPT neurons. 332 Such disfacilitation would impair higher cortical function.…”

Sleep, Anesthesiology, and the Neurobiology of Arousal State Control

“…28,30 Muscarinic receptors of the M1 subtype are located throughout the cortex. 347 The acetylcholine release data are consistent with electrophysiologic evidence showing that adenosine A 1 receptors cause presynaptic disfacilitation 348 and postsynaptic inhibition 349 of cholinergic LDT/PPT neurons. 332 Such disfacilitation would impair higher cortical function.…”

The Effect of Preoperative Aminophylline on the Recovery Profile After Major Pelvi-abdominal Surgeries: a Randomized Controlled Double-blinded Study

“…The results of this study showed that premedication with aminophylline 2 or 4 mg/kg IV reduced time till BIS reached 80after discontinuation of anesthesia,time of ROC and the extubation time without affecting the discharge time compared to the control group and without statistically signi cant differences between the groups treated by aminophylline 2 or 4 mg.Aminophylline is a non-selective adenosine receptor antagonist used for treatment of asthma and chronic obstructive pulmonary disease [13] and it has been used to antagonize the effects of anesthetic and analgesic agents [14].Its neuronal excitability is due to the inhibition ofgamma-Aminobutyric acid and central adenosine receptors [15].Adenosine is involved in sleep and has a sedative and hypnotic effect [5,16,17,18],its systemic administration enhanceshypnosis induced by IV anesthetics and decreased intraoperative anesthetic requirements [19].Perfusion of A1 receptor-selective antagonists as caffeine or theophylline increases wakefulness, in the study of Turan et,al [5] the LOC was prolonged by aminophylline compared with saline in volunteers who were given aminophylline 6 mg/kg IV,followed by 1.5 mg/kg/h; time to LOC was7.7 ± 2.03 min for the volunteer group versus 5.1 ± 0.75 min for the saline group and the time to ROC was shorter 6.18 ± 3.96 min. for the volunteer group versus 12.2 ± 4.73 min for the saline group, P = 0.03) which coincides with the results of this study,Turan et al ( 5) also reported that the propofol dose at LOC was larger with aminophylline treated group which was reported in the presented study and they reported that the minimum bispectral indexwas greater with aminophylline more than the saline group (51 ± 15 vs 38 ± 9, P = 0.03).Turan et al (3) concluded that the recovery from sevo urane anesthesia and BISscores were improved in early period when aminophylline wasgiven at emerging from anesthesia.Ghaffaripour et al (20) concluded that injection of aminophylline at emergence time signi cantly increased BIS and reduced the recovery time in patients anesthetized with total intravenous anesthesia.…”

Neuronal mechanisms of adenosine A2A receptors in the loss of consciousness induced by propofol general anesthesia with functional magnetic resonance imaging

“…Physical sleep and anesthesia are almost similar on many fronts, including the responsiveness to external stimuli (Nelson et al, 2004), brain electrical activity (Sleigh et al, 1999) and metabolic activity (Alkire et al, 1999). Additionally, adenosine has been reported to have the ability to shorten the onset time and extend the duration of propofol (Kaputlu et al, 1998), similarly the A 1 receptor agonist (N6-p-sulfophenyladenosine) has been shown to increase the time needed to recover from halothane anesthesia (Tanase, Baghdoyan, & Lydic, 2003). However, the role of A 2A R in affecting showed that the A 2A R agonist prolonged the duration of propofol-induced LOC, while the A 2A R antagonist shortened it.…”

Sleep, Anesthesiology, and the Neurobiology of Arousal State Control

“…28,30 Muscarinic receptors of the M1 subtype are located throughout the cortex. 347 The acetylcholine release data are consistent with electrophysiologic evidence showing that adenosine A 1 receptors cause presynaptic disfacilitation 348 and postsynaptic inhibition 349 of cholinergic LDT/PPT neurons. 332 Such disfacilitation would impair higher cortical function.…”

The Effect of Preoperative Aminophylline on the Recovery Profile After Major Pelvi-abdominal Surgeries: a Randomized Controlled Double-blinded Study

“…The results of this study showed that premedication with aminophylline 2 or 4 mg/kg IV reduced time till BIS reached 80after discontinuation of anesthesia,time of ROC and the extubation time without affecting the discharge time compared to the control group and without statistically signi cant differences between the groups treated by aminophylline 2 or 4 mg.Aminophylline is a non-selective adenosine receptor antagonist used for treatment of asthma and chronic obstructive pulmonary disease [13] and it has been used to antagonize the effects of anesthetic and analgesic agents [14].Its neuronal excitability is due to the inhibition ofgamma-Aminobutyric acid and central adenosine receptors [15].Adenosine is involved in sleep and has a sedative and hypnotic effect [5,16,17,18],its systemic administration enhanceshypnosis induced by IV anesthetics and decreased intraoperative anesthetic requirements [19].Perfusion of A1 receptor-selective antagonists as caffeine or theophylline increases wakefulness, in the study of Turan et,al [5] the LOC was prolonged by aminophylline compared with saline in volunteers who were given aminophylline 6 mg/kg IV,followed by 1.5 mg/kg/h; time to LOC was7.7 ± 2.03 min for the volunteer group versus 5.1 ± 0.75 min for the saline group and the time to ROC was shorter 6.18 ± 3.96 min. for the volunteer group versus 12.2 ± 4.73 min for the saline group, P = 0.03) which coincides with the results of this study,Turan et al ( 5) also reported that the propofol dose at LOC was larger with aminophylline treated group which was reported in the presented study and they reported that the minimum bispectral indexwas greater with aminophylline more than the saline group (51 ± 15 vs 38 ± 9, P = 0.03).Turan et al (3) concluded that the recovery from sevo urane anesthesia and BISscores were improved in early period when aminophylline wasgiven at emerging from anesthesia.Ghaffaripour et al (20) concluded that injection of aminophylline at emergence time signi cantly increased BIS and reduced the recovery time in patients anesthetized with total intravenous anesthesia.…”

Neuronal mechanisms of adenosine A2A receptors in the loss of consciousness induced by propofol general anesthesia with functional magnetic resonance imaging

“…Physical sleep and anesthesia are almost similar on many fronts, including the responsiveness to external stimuli (Nelson et al, 2004), brain electrical activity (Sleigh et al, 1999) and metabolic activity (Alkire et al, 1999). Additionally, adenosine has been reported to have the ability to shorten the onset time and extend the duration of propofol (Kaputlu et al, 1998), similarly the A 1 receptor agonist (N6-p-sulfophenyladenosine) has been shown to increase the time needed to recover from halothane anesthesia (Tanase, Baghdoyan, & Lydic, 2003). However, the role of A 2A R in affecting showed that the A 2A R agonist prolonged the duration of propofol-induced LOC, while the A 2A R antagonist shortened it.…”

Sleep, Anesthesiology, and the Neurobiology of Arousal State Control

“…28,30 Muscarinic receptors of the M1 subtype are located throughout the cortex. 347 The acetylcholine release data are consistent with electrophysiologic evidence showing that adenosine A 1 receptors cause presynaptic disfacilitation 348 and postsynaptic inhibition 349 of cholinergic LDT/PPT neurons. 332 Such disfacilitation would impair higher cortical function.…”

The Effect of Preoperative Aminophylline on the Recovery Profile After Major Pelvi-abdominal Surgeries: a Randomized Controlled Double-blinded Study

“…The results of this study showed that premedication with aminophylline 2 or 4 mg/kg IV reduced time till BIS reached 80after discontinuation of anesthesia,time of ROC and the extubation time without affecting the discharge time compared to the control group and without statistically signi cant differences between the groups treated by aminophylline 2 or 4 mg.Aminophylline is a non-selective adenosine receptor antagonist used for treatment of asthma and chronic obstructive pulmonary disease [13] and it has been used to antagonize the effects of anesthetic and analgesic agents [14].Its neuronal excitability is due to the inhibition ofgamma-Aminobutyric acid and central adenosine receptors [15].Adenosine is involved in sleep and has a sedative and hypnotic effect [5,16,17,18],its systemic administration enhanceshypnosis induced by IV anesthetics and decreased intraoperative anesthetic requirements [19].Perfusion of A1 receptor-selective antagonists as caffeine or theophylline increases wakefulness, in the study of Turan et,al [5] the LOC was prolonged by aminophylline compared with saline in volunteers who were given aminophylline 6 mg/kg IV,followed by 1.5 mg/kg/h; time to LOC was7.7 ± 2.03 min for the volunteer group versus 5.1 ± 0.75 min for the saline group and the time to ROC was shorter 6.18 ± 3.96 min. for the volunteer group versus 12.2 ± 4.73 min for the saline group, P = 0.03) which coincides with the results of this study,Turan et al ( 5) also reported that the propofol dose at LOC was larger with aminophylline treated group which was reported in the presented study and they reported that the minimum bispectral indexwas greater with aminophylline more than the saline group (51 ± 15 vs 38 ± 9, P = 0.03).Turan et al (3) concluded that the recovery from sevo urane anesthesia and BISscores were improved in early period when aminophylline wasgiven at emerging from anesthesia.Ghaffaripour et al (20) concluded that injection of aminophylline at emergence time signi cantly increased BIS and reduced the recovery time in patients anesthetized with total intravenous anesthesia.…”

Neuronal mechanisms of adenosine A2A receptors in the loss of consciousness induced by propofol general anesthesia with functional magnetic resonance imaging

“…Physical sleep and anesthesia are almost similar on many fronts, including the responsiveness to external stimuli (Nelson et al, 2004), brain electrical activity (Sleigh et al, 1999) and metabolic activity (Alkire et al, 1999). Additionally, adenosine has been reported to have the ability to shorten the onset time and extend the duration of propofol (Kaputlu et al, 1998), similarly the A 1 receptor agonist (N6-p-sulfophenyladenosine) has been shown to increase the time needed to recover from halothane anesthesia (Tanase, Baghdoyan, & Lydic, 2003). However, the role of A 2A R in affecting showed that the A 2A R agonist prolonged the duration of propofol-induced LOC, while the A 2A R antagonist shortened it.…”