Inhaled anesthetics and immobility: mechanisms, mysteries, and minimum alveolar anesthetic concentration

Anesth Analg. 2003 Sep;97(3):718-740. doi: 10.1213/01.ANE.0000081063.76651.33.

Abstract

Studies using molecular modeling, genetic engineering, neurophysiology/pharmacology, and whole animals have advanced our understanding of where and how inhaled anesthetics act to produce immobility (minimum alveolar anesthetic concentration; MAC) by actions on the spinal cord. Numerous ligand- and voltage-gated channels might plausibly mediate MAC, and specific amino acid sites in certain receptors present likely candidates for mediation. However, in vivo studies to date suggest that several channels or receptors may not be mediators (e.g., gamma-aminobutyric acid A, acetylcholine, potassium, 5-hydroxytryptamine-3, opioids, and alpha(2)-adrenergic), whereas other receptors/channels (e.g., glycine, N-methyl-D-aspartate, and sodium) remain credible candidates.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Anesthetics, Inhalation / administration & dosage
  • Anesthetics, Inhalation / pharmacokinetics
  • Anesthetics, Inhalation / pharmacology*
  • Animals
  • Genetic Engineering
  • Humans
  • In Vitro Techniques
  • Ion Channels / drug effects
  • Models, Molecular
  • Movement / drug effects*
  • Pulmonary Alveoli / metabolism*
  • Spinal Cord / drug effects
  • Spinal Cord / physiology

Substances

  • Anesthetics, Inhalation
  • Ion Channels