Towards a Potent and Rapidly Reversible Dexmedetomidine-based General Anesthetic

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2023 Sep 26

PMID 37751454

Authors

Zheng Xie

Robert Fong

Aaron P Fox

Affiliations

Soon will be listed here.

Abstract

Our results suggest that Dex supplemented with a low dose of a second agent creates a potent anesthetic that is rapidly reversed by atipamezole and caffeine.

References

Jevtovic-Todorovic V . Detrimental effects of general anaesthesia on young primates: are we closer to understanding the link?. Br J Anaesth. 2021; 126(3):575-577. DOI: 10.1016/j.bja.2020.12.019. View

Erasso D, Camporesi E, Mangar D, Saporta S . Effects of isoflurane or propofol on postnatal hippocampal neurogenesis in young and aged rats. Brain Res. 2013; 1530:1-12. DOI: 10.1016/j.brainres.2013.07.035. View

Akeju O, Brown E . Neural oscillations demonstrate that general anesthesia and sedative states are neurophysiologically distinct from sleep. Curr Opin Neurobiol. 2017; 44:178-185. PMC: 5520989. DOI: 10.1016/j.conb.2017.04.011. View

Fox A, Wagner K, Towle V, Xie K, Xie Z . Caffeine reverses the unconsciousness produced by light anesthesia in the continued presence of isoflurane in rats. PLoS One. 2020; 15(11):e0241818. PMC: 7643991. DOI: 10.1371/journal.pone.0241818. View

Sharma P, Gombar S, Ahuja V, Jain A, Dalal U . Sevoflurane sparing effect of dexmedetomidine in patients undergoing laparoscopic cholecystectomy: A randomized controlled trial. J Anaesthesiol Clin Pharmacol. 2018; 33(4):496-502. PMC: 5791264. DOI: 10.4103/joacp.JOACP_144_16. View

Eckenhoff R, Maze M, Xie Z, Culley D, Goodlin S, Zuo Z . Perioperative Neurocognitive Disorder: State of the Preclinical Science. Anesthesiology. 2019; 132(1):55-68. PMC: 6913778. DOI: 10.1097/ALN.0000000000002956. View

Zhang Y, Dong Y, Wu X, Lu Y, Xu Z, Knapp A . The mitochondrial pathway of anesthetic isoflurane-induced apoptosis. J Biol Chem. 2009; 285(6):4025-4037. PMC: 2823544. DOI: 10.1074/jbc.M109.065664. View

Fong T, Tulebaev S, Inouye S . Delirium in elderly adults: diagnosis, prevention and treatment. Nat Rev Neurol. 2009; 5(4):210-20. PMC: 3065676. DOI: 10.1038/nrneurol.2009.24. View

Eger 2nd E . Age, minimum alveolar anesthetic concentration, and minimum alveolar anesthetic concentration-awake. Anesth Analg. 2001; 93(4):947-53. DOI: 10.1097/00000539-200110000-00029. View

10.

Wang D, Kaneshwaran K, Lei G, Mostafa F, Wang J, Lecker I . Dexmedetomidine Prevents Excessive γ-Aminobutyric Acid Type A Receptor Function after Anesthesia. Anesthesiology. 2018; 129(3):477-489. DOI: 10.1097/ALN.0000000000002311. View

11.

Daiello L, Racine A, Gou R, Marcantonio E, Xie Z, Kunze L . Postoperative Delirium and Postoperative Cognitive Dysfunction: Overlap and Divergence. Anesthesiology. 2019; 131(3):477-491. PMC: 6692220. DOI: 10.1097/ALN.0000000000002729. View

12.

Ding L, Zhang H, Mi W, Wang T, He Y, Zhang X . Effects of dexmedetomidine on anesthesia recovery period and postoperative cognitive function of patients after robot-assisted laparoscopic radical cystectomy. Int J Clin Exp Med. 2015; 8(7):11388-95. PMC: 4565337. View

13.

Veselis R, Pryor K, Reinsel R, Mehta M, Pan H, Johnson Jr R . Low-dose propofol-induced amnesia is not due to a failure of encoding: left inferior prefrontal cortex is still active. Anesthesiology. 2008; 109(2):213-24. PMC: 2599915. DOI: 10.1097/ALN.0b013e31817fd8ae. View

14.

Slikker Jr W, Zou X, Hotchkiss C, Divine R, Sadovova N, Twaddle N . Ketamine-induced neuronal cell death in the perinatal rhesus monkey. Toxicol Sci. 2007; 98(1):145-58. DOI: 10.1093/toxsci/kfm084. View

15.

Pertovaara A, Haapalinna A, Sirvio J, Virtanen R . Pharmacological properties, central nervous system effects, and potential therapeutic applications of atipamezole, a selective alpha2-adrenoceptor antagonist. CNS Drug Rev. 2006; 11(3):273-88. PMC: 6741735. DOI: 10.1111/j.1527-3458.2005.tb00047.x. View

16.

Remaury A, Larrouy D, Daviaud D, Rouot B, Paris H . Coupling of the alpha 2-adrenergic receptor to the inhibitory G-protein Gi and adenylate cyclase in HT29 cells. Biochem J. 1993; 292 ( Pt 1):283-8. PMC: 1134302. DOI: 10.1042/bj2920283. View

17.

Pedemonte J, Plummer G, Chamadia S, Locascio J, Hahm E, Ethridge B . Electroencephalogram Burst-suppression during Cardiopulmonary Bypass in Elderly Patients Mediates Postoperative Delirium. Anesthesiology. 2020; 133(2):280-292. PMC: 7365754. DOI: 10.1097/ALN.0000000000003328. View

18.

Wang C, Chen W, Zhang Y, Lin S, He H . Update on the Mechanism and Treatment of Sevoflurane-Induced Postoperative Cognitive Dysfunction. Front Aging Neurosci. 2021; 13:702231. PMC: 8296910. DOI: 10.3389/fnagi.2021.702231. View

19.

Chen H, Li F . Effect of Dexmedetomidine with Different Anesthetic Dosage on Neurocognitive Function in Elderly Patients After Operation Based on Neural Network Model. World Neurosurg. 2020; 138:688-695. DOI: 10.1016/j.wneu.2020.01.012. View

20.

Venn R, Bradshaw C, Spencer R, Brealey D, Caudwell E, Naughton C . Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit. Anaesthesia. 1999; 54(12):1136-42. DOI: 10.1046/j.1365-2044.1999.01114.x. View