Orexin-A facilitates emergence of the rat from isoflurane anesthesia via mediation of the basal forebrain

Zhang, Lina; Yang, Chunmei; Ouyang, Pengrong; Zhang, Zhichao; Ran, Mingzi; Li, Tong; Dong, Hailong; Liu, Yong

doi:10.1016/j.npep.2016.02.003

Cited by 33 publications

(39 citation statements)

References 35 publications

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“…Interestingly, orexin neurons could not be activated by noxious stimuli under anesthesia by isoflurane. It was reported that isoflurane and sevoflurane inhibit c-Fos expression in orexin neurons 57 , that selective ablation of orexin neurons delays the emergence from anesthesia 57 , and that orexin A facilitates emergence of the rat from isoflurane anesthesia 58 . These findings suggest the possibility that inhibition of orexin neurons by anesthetics plays a role in maintaining stable anesthesia.…”

Section: Discussionmentioning

confidence: 99%

The integrative role of orexin/hypocretin neurons in nociceptive perception and analgesic regulation

Inutsuka

Yamashita

Chowdhury

et al. 2016

Sci Rep

101

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The level of wakefulness is one of the major factors affecting nociception and pain. Stress-induced analgesia supports an animal’s survival via prompt defensive responses against predators or competitors. Previous studies have shown the pharmacological effects of orexin peptides on analgesia. However, orexin neurons contain not only orexin but also other co-transmitters such as dynorphin, neurotensin and glutamate. Thus, the physiological importance of orexin neuronal activity in nociception is unknown. Here we show that adult-stage selective ablation of orexin neurons enhances pain-related behaviors, while pharmacogenetic activation of orexin neurons induces analgesia. Additionally, we found correlative activation of orexin neurons during nociception using fiber photometry recordings of orexin neurons in conscious animals. These findings suggest an integrative role for orexin neurons in nociceptive perception and pain regulation.

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Section: Discussionmentioning

confidence: 99%

The integrative role of orexin/hypocretin neurons in nociceptive perception and analgesic regulation

Inutsuka

Yamashita

Chowdhury

et al. 2016

Sci Rep

101

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“…Previous studies have established that physiological sleep is an active process rather than a passive process such as a suppression of wakefulness. For example, orexin, an endogenous wakefulness-promoting substance, also facilitates the emergence from anesthesia, but not the delayed induction of anesthesia [2,[9][10][11]. Another endogenous wakefulness-promoting substance, neuropeptide S, also facilitates the emergence from anesthesia, but not induction [12].…”

Section: Anesthesia and Sleep: From The Viewpoint Of Basic Medicinementioning

confidence: 99%

Sleep science in anesthesiology

Kushikata

2019

J Anesth

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“…A series of studies proved that it facilitated AE in both intravenous[ 24 ], and inhaled general anesthesia[ 25 ]. More recently, Zhang et al[ 26 ] demonstrated in rats that isoflurane depressed the excitability of orexinergic neurons. Although both orexins ( i.e ., orexin-A, OXA, and orexin-B, OXB) promoted emergence, OXA played a more significant role (through orexin receptor-1).…”

Section: Neurobiology Of Emergencementioning

confidence: 99%

“…Clinical investigations should be carried out to better clarify results, and discrepancies of preclinical and clinical studies. Although OXA has been proved to be involved in arousal from general anesthesia in rodents[ 24 , 26 ], and the Kushikata[ 59 ]’s studies showed that plasma OXA significantly increased at AE from both propofol and sevoflurane anesthesia, Wang et al[ 60 ] proved that higher plasma OXA concentrations were not associated with a reduction in AE time in elderly patients. However, these patients showed a higher level of plasma OXA compared to young patients[ 60 ], suggesting an age-dependent difference in the orexin-induced anesthesia arousal regulation.…”

Section: Translational Data and Research Perspectivesmentioning

confidence: 99%

“…Certainly, many aspects of the anesthetics are still to be elucidated. For instance, it has been demonstrated that the OS could be another possible target for isoflurane[ 26 ], whereas the role of serotonergic neurones in dorsal raphe nucleus implicated in the mechanisms of general anesthesia[ 63 ] on the orexinergic signal should be an interesting field of research for investigating the linkage between AE modalities and RoC features, such as pain and mood. Effects of specific antinociceptive interventions ( e.g ., neuraxial anesthesia) as potential mechanisms interfering with emergence processes and clinical consequences should be addressed in order to prove specific experimental findings such as the brainstem involvement in arousal dynamics.…”

Section: Translational Data and Research Perspectivesmentioning

confidence: 99%

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Towards a better understanding of anesthesia emergence mechanisms: Research and clinical implications

Cascella

Bimonte

Muzio³

2018

WJM

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Emergence from anesthesia (AE) is the ending stage of anesthesia featuring the transition from unconsciousness to complete wakefulness and recovery of consciousness (RoC). A wide range of undesirable complications, including coughing, respiratory/cardiovascular events, and mental status changes such as emergence delirium, and delayed RoC, may occur during this critical phase. In general anesthesia processes, induction and AE represent a neurobiological example of “hysteresis”. Indeed, AE mechanisms should not be simply considered as reverse events of those occurring in the induction phase. Anesthesia-induced loss of consciousness (LoC) and AE until RoC are quite distinct phenomena with, in part, a distinct neurobiology. Althoughanaesthetics produce LoC mostly by affecting cortical connectivity, arousal processes at the end of anesthesia are triggered by structures deep in the brain, rather than being induced within the neocortex. This work aimed to provide an overview on AE processes research, in terms of mechanisms, and EEG findings. Because most of the research in this field concerns preclinical investigations, translational suggestions and research perspectives are proposed. However, little is known about the relationship between AE neurobiology, and potential complications occurring during the emergence, and after the RoC. Thus, another scope of this review is to underline why a better understanding of AE mechanisms could have significant clinical implications, such as improving the patients’ quality of recovery, and avoiding early and late postoperative complications.

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Orexin-A facilitates emergence of the rat from isoflurane anesthesia via mediation of the basal forebrain

Cited by 33 publications

References 35 publications

The integrative role of orexin/hypocretin neurons in nociceptive perception and analgesic regulation

The integrative role of orexin/hypocretin neurons in nociceptive perception and analgesic regulation

Sleep science in anesthesiology

Towards a better understanding of anesthesia emergence mechanisms: Research and clinical implications

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