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The Journal of Neuroscience, December 15, 2000, 20(24):9242-9251

Antinociceptive Action of Nitrous Oxide Is Mediated by Stimulation of Noradrenergic Neurons in the Brainstem and Activation of alpha 2B Adrenoceptors

Shigehito Sawamura1, 3, Wade S. Kingery2, 4, M. Frances Davies1, 3, Geeta S. Agashe1, 3, J. David Clark1, 3, Brian K. Kobilka5, Toshizaku Hashimoto6, and Mervyn Maze6

Departments of 1 Anesthesia and 2 Functional Restoration, Stanford University School of Medicine, Stanford, California 94305, 3 Anesthesiology Service and 4 Physical Medicine and Rehabilitation Service, Veterans Affairs, Palo Alto Health Care System, Palo Alto, California 94304, 5 Howard Hughes Medical Institute, Stanford University, Stanford, California 94305, and 6 Magill Department of Anaesthetics, Imperial College School of Medicine, London SW10 9NH, United Kingdom

Although nitrous oxide (N2O) has been used to facilitate surgery for >150 years, its molecular mechanism of action is not yet defined. Having established that N2O-induced release of norepinephrine mediates the analgesic action at alpha 2 adrenoceptors in the spinal cord, we now investigated whether activation of noradrenergic nuclei in the brainstem is responsible for this analgesic action and which alpha 2 adrenoceptor subtype mediates this property. In rats, Fos immunoreactivity was examined in brainstem noradrenergic nuclei after exposure to nitrous oxide. After selective lesioning of noradrenergic nuclei by intracerebroventricular application of the mitochondrial toxin saporin, coupled to the antibody directed against dopamine beta  hydroxylase (Dbeta H-saporin), the analgesic and sedative actions of N2O were determined. Null mice for each of the three alpha 2 adrenoceptor subtypes (alpha 2A, alpha 2B, and alpha 2C), and their wild-type cohorts, were tested for their antinociceptive and sedative response to N2O. Exposure to N2O increased expression of Fos immunoreactivity in each of the pontine noradrenergic nuclei (A5, locus coeruleus, and A7). Dbeta H-saporin treatment eliminated nearly all of the catecholamine-containing neurons in the pons and blocked the analgesic but not the sedative effects of N2O. Null mice for the alpha 2B adrenoceptor subtype exhibited a reduced or absent analgesic response to N2O, but their sedative response to N2O was intact. Our results support a pivotal role for noradrenergic pontine nuclei and alpha 2B adrenoceptors in the analgesic, but not the sedative effects of N2O. Previously we demonstrated that the analgesic actions of alpha 2 adrenoceptor agonists are mediated by the alpha 2A subtype; taken together with these data we propose that exogenous and endogenous alpha 2 adrenoceptor ligands activate different alpha 2 adrenoceptor subtypes to produce their analgesic action.

Key words: nitrous oxide; locus coeruleus; noradrenergic; analgesia; anesthesia; Fos immunoreactivity


Copyright © 2000 Society for Neuroscience  0270-6474/00/20249242-10$05.00/0


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