The Effects of Desflurane on the Nervous System

Péreón, Yann; Bernard, Jean-Marc; Genet, Robert; Petitfaux, F; Guihéneuc, P

doi:10.1097/00000539-199908000-00046

Cited by 14 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mechanism by which inhalational anesthetics potentiate the effects of muscle relaxants is unknown. The proposed mechanisms include a central effect on alpha-motor neurons and interneuronal synapses [8], inhibition of postsynaptic nicotinic acetylcholine receptors [9], or augmentation of the antagonist’s affinity at the receptor site [10]. In addition, more than one mechanism is simultaneously involved and different inhalational anesthetics may not act exactly in the same way [11].…”

Section: Discussionmentioning

confidence: 99%

The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population

Lee

Koh

et al. 2015

BMC Anesthesiol

View full text Add to dashboard Cite

BackgroundWe conducted a prospective, randomized, multicenter study to evaluate the differences in the blocking effect of different doses of rocuronium between sevoflurane- or propofol-remifentanil anesthesia in an Asian population.MethodsA total of 368 ASA I–II patients was enrolled. Anesthesia was induced with 2.0 mg/kg propofol and 0.1 μg/kg/min remifentanil (TIVA) or 5.0 vol.% sevoflurane with 0.1 μg/kg/min remifentanil (SEVO). Tracheal intubation was facilitated at 180 s after the administration of rocuronium at 0.3, 0.6, or 0.9 mg/kg and then intubation condition was evaluated. The time to maximum block and recovery profile were monitored by TOF stimulation of the ulnar nerve and by recording the adductor pollicis response using acceleromyography.ResultsThe numbers of patients with clinically acceptable intubation conditions were 41, 82, and 97 % (TIVA) and 34, 85, and 90 % (SEVO) at each dose of rocuronium, respectively. There were no significant differences in the time to maximum block between groups at each rocuronium dose. There were significant differences in the recovery to a train-of-four ratio of 90 % between the groups: 42.7 (19.5), 74.8 (29.9), and 118.4 (35.1) min (TIVA) and 66.5 (39.3), 110.2 (43.5), and 144.4 (57.5) min (SEVO) at 0.3, 0.6, and 0.9 mg/kg, respectively (P < 0.001).ConclusionsThere are no significant differences in intubation conditions between propofol-remifentanil and sevoflurane-remifentanil anesthesia at the same dose of rocuronium. The type of anesthetic does not significantly influence the time to maximum block by rocuronium. Rocuronium at a dose of 0.9 mg/kg should be used for better intubation conditions with both anesthesia regimens in an Asian population.Trial registrationUMIN-CTR Clinical Trial (http://www.umin.ac.jp/ctr/index.htm; UMIN#000007289; date of registration 14th February 2012).

show abstract

Section: Discussionmentioning

confidence: 99%

The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population

Lee

Koh

et al. 2015

BMC Anesthesiol

View full text Add to dashboard Cite

show abstract

“…The peripheral axons of motor neurones distal to the spinal cord probably do not contribute to immobility, nor do actions at the neuromuscular junction. 49 Conduction in large-diameter myelinated axons, like that in motor neurones, is not sensitive to anaesthetic agents at concentrations relevant to MAC, as many studies have shown. Moreover, conduction in primary sensory nerve axons is relatively unaffected, although impulse generation at peripheral nociceptors may be modi®ed.…”

Section: Cellular Sites Of Anaesthetic Action Within the Spinal Cordmentioning

confidence: 99%

In vitro networks: subcortical mechanisms of anaesthetic action

Kendig

2002

British Journal of Anaesthesia

View full text Add to dashboard Cite

Subcortical in vitro studies at the Molecular Mechanisms ConferenceThere were few presentations at the recent International Conference on Basic and Molecular Mechanisms of Anaesthesia (MAC2001) concerning subcortical anaesthetic actions studied in vitro. In addition to the spinal cord studies from the author's laboratory presented in detail here and the review of the associated literature, there was one other presentation on the spinal cord slice, which will be covered in the appropriate section below (C. Grasshoff and B. Antkowiak, Effect of volatile anaesthetics on action potential ®ring of spinal neurones in organotypic slice cultures). In a study of the effects of general anaesthetics on thalamic slices (E. Puil, Thalamic effects of general anesthetics: similar and dissimilar actions of iso¯urane and barbiturates), Puil found that iso¯urane in the medial geniculate body shunts tonic ®ring of both sodium and calcium channelmediated bursts by increasing leak conductance. Similar actions were observed for high concentrations of pentobarbital, but low concentrations enhanced excitation and bursting. Pentobarbital actions were not blocked by bicuculline. These results are relevant to the role of the thalamus in mediating arousal to auditory stimuli and its blockade by anaesthetics. In a study on cerebellar slices (M. Debus, K. Unertl and B. Antkowiak, The potency of general anesthetics to suppress spontaneous neuronal activity in cerebellar acute slices compared to neocortical slice cultures), the authors found that a variety of inhalation agents, ethanol and propofol suppressed mean ®ring rates more potently in neocortical slices than in cerebellar slices by approximately 5-fold, and the potency ratios among the agents were similar for the two preparations. The results are relevant to the actions of anesthetics on locomotion and balance.

show abstract

“…Our results show that sevoflurane had no effect on LSR or orbicularis oculi M wave latencies, indicating that up to 1 MAC sevoflurane did not affect nerve conduction velocities which is in agreement with previous studies. 33,34 This result is further inconsistent with the peripheral hypothesis of LSR because ephaptic transmission is facilitated by conduction slowing. 9 However, we cannot completely rule out the peripheral theory of the LSR because we did not investigate the effect of high concentrations of sevoflurane used for > 30 minutes on latency.…”

Section: Discussionmentioning

confidence: 67%

Influence of Minimum Alveolar Concentration and Inhalation Duration of Sevoflurane on Facial Nerve Electromyography in Hemifacial Spasm: A Randomized Controlled Trial

Yang¹,

Chen

Zhao

et al. 2022

Journal of Neurosurgical Anesthesiology

View full text Add to dashboard Cite

Background: The lateral spread response (LSR) is an electromyography feature of hemifacial spasm; intraoperative reduction in the LSR is associated with positive surgical outcomes. This study examined the effects of different minimum alveolar concentrations (MACs) and durations of sevoflurane inhalation on the LSR.Methods: Eighty patients undergoing microvascular decompression surgery for hemifacial spasm were randomly allocated to receive propofol-remifentanil total intravenous anesthesia alone or in combination with sevoflurane at 0.5, 0.75, or 1 MAC. The LSR and orbicularis oculi muscle wave were recorded before and at 15 and 30 minutes after the start of sevoflurane administration.Results: Sevoflurane reduced the LSR amplitude in a dose-dependent and duration-dependent manner. The curve representing the LSR amplitude preservation ratio change according to sevoflurane concentration is best fitted by regression analysis using a cubic model, as the cubic equations had the largest coefficient of determination; at 15 minutes (R 2 = 0.76, F = 78.36, P < 0.05) and at 30 minutes (R 2 = 0.882, F = 189.94, P < 0.05). The inhibitory effect of sevoflurane on the LSR amplitude was greater in the first 15 minutes than in the second 15 minutes of sevoflurane administration. Sevoflurane at 1 MAC for 30 minutes mildly decreased the amplitude of the orbicularis oculi muscle wave. The latencies of the LSR and the orbicularis oculi muscle wave were not affected by sevoflurane at all MACs studied. Conclusions:The combination of intravenous propofol-remifentanil anesthesia with 0.5 MAC sevoflurane allows reliable intraoperative LSR monitoring in hemifacial spasm patients. Our findings support the central rather than peripheral hypothesis of the LSR.

show abstract

The Effects of Desflurane on the Nervous System

Cited by 14 publications

References 20 publications

The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population

The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population

In vitro networks: subcortical mechanisms of anaesthetic action

Influence of Minimum Alveolar Concentration and Inhalation Duration of Sevoflurane on Facial Nerve Electromyography in Hemifacial Spasm: A Randomized Controlled Trial

Contact Info

Product

Resources

About