Abstract:
:The experimental effort that has been expended in investigating the effects of general anaesthetics on LGICs has been enormous over the past decade. Members of all three LGIC superfamilies have been examined using electrophysiological techniques. Anaesthetics that have been examined include volatile anaesthetics, gaseous anaesthetics, alcohols, i.v. anaesthetics and non-immobilizers. Obsolete anaesthetics (ether, cyclopropane, butane) have been used in order to increase the variability of the structure and polarity of experimental compounds. The tools of molecular biology have been used to make chimeric receptors and to make single-site mutations. Interestingly, this work has been taking place in parallel with efforts to understand the structure of these proteins. Anaesthetic research often stimulates structural research as well as vice versa. There are some common themes in the interactions between anaesthetics and the three superfamilies of LGICs. In many cases, anaesthetics have both inhibitory and potentiating effects on the channels. It is likely that the number of examples of this will increase when experiments are designed to look specifically for one or the other type of effect. So we must conclude that there are multiple binding sites for anaesthetics on LGICs. The degree of inhibition or potentiation is not easily predictable. In retrospect, this is not surprising when we consider that the sensitivity of a channel to anaesthetics can be altered by a single amino-acid mutation. The large structural differences between the cys-loop, glutamate-activated and P2X superfamilies do not lead to large differences in anaesthetic sensitivity. It is the smaller, almost insignificant, changes that do this. This observation that small changes may lead to large effects reinforces the idea that at least some of the interactions between anaesthetics and LGICs are direct drug-protein interactions that are not mediated by the lipids. This review has not addressed the question of whether the effects of anaesthetics seen on LGICs are relevant to anaesthesia. This question cannot really be answered at present. Although potent effects can be observed on the channels themselves, we have only begun to try to understand whether these effects are important for a synapse, a neuronal circuit or the function of an animal's nervous system. We have studied the trees; now we must go on to study the forest and the ecosystem.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Dilger JPdoi
10.1093/bja/aef161subject
Has Abstractpub_date
2002-07-01 00:00:00pages
41-51issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)37589-Xjournal_volume
89pub_type
杂志文章,评审abstract::The arterial to end-tidal PCO2 difference (PaCO2-PE'CO2) was measured in five anaesthetized dogs during controlled ventilation at 0.25 Hz (15 b.p.m.) and during high frequency jet ventilation at 1, 3 and 5 Hz. Because of the slow response of the infra-red carbon dioxide analyser, satisfactory recordings of end-tidal c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.2.240
更新日期:1987-02-01 00:00:00
abstract::We have investigated 60 patients in a prospective double-blind, placebo-controlled study to assess the efficacy of EMLA (Eutectic Mixture of Local Anaesthetics) cream to provide analgesia during extracorporeal shock wave lithotripsy (ESWL) with a second generation lithotriptor. Before operation, EMLA or placebo cream ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/69.4.399
更新日期:1992-10-01 00:00:00
abstract::We carried out a randomized prospective study in 60 patients who had undergone major abdominal surgery for cancer. For postoperative pain control, 30 patients received continuous extradural infusion of 0.125% bupivacaine 12.5 mg h-1 and morphine 0.25 mg h-1 (EXI group) and 30 received patient-controlled analgesia (PCA...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/80.6.742
更新日期:1998-06-01 00:00:00
abstract::We have compared the effects of the anaesthetic gases nitrogen and argon on adenosine diphosphate (ADP)-induced human blood platelet aggregation with the effects of the non-anaesthetic gas helium. All three gases showed dose-dependent inhibition of platelet aggregation. For nitrogen and argon there was a linear relati...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.1.77
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:The influence of common disturbances seen in preeclampsia, such as changes in strong ions and weak acids (particularly albumin) on acid-base status, has not been fully elucidated. The aims of this study were to provide a comprehensive acid-base analysis in severe preeclampsia and to identify potential new bi...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/aev221
更新日期:2015-08-01 00:00:00
abstract::In this report we present the case of a 77-yr-old man who underwent resection of the upper lobe of the left lung for a carcinoma, six weeks after percutaneous transluminal coronary angioplasty (PTCA) with stenting of the left anterior descending (LAD) and circumflex coronary arteries. Antiplatelet therapy with clopido...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh110
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Guidelines recommend discontinuation of clopidogrel for 7 days before a neuraxial injection, while other directives suggest that 5 days might be adequate. We examined the time course of antiplatelet activity after clopidogrel discontinuation in patients undergoing epidural injections. METHODS:Thirteen patie...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer298
更新日期:2011-12-01 00:00:00
abstract::The problems of selection of tracheal tubes, and the need for a rationale, are outlined. Tracheal tubes of 7.5 mm and 8.5 mm i.d. are recommended for female and male patients, respectively. Tracheal size was determined using high pressure-low volume cuffs as measuring devices. The average diameter of the cuff at seal ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.1.111
更新日期:1986-01-01 00:00:00
abstract::We have compared, in a randomized, double-blind study, the pharmacokinetics of ropivacaine and bupivacaine during labour. Total and free plasma concentrations of ropivacaine and bupivacaine were measured after the first of two extradural doses. The main dose was 20 mg (test dose) and 30 mg, with a top-up dose of 25 mg...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/79.5.558
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Cardiac surgery with cardiopulmonary bypass (CPB) is commonly perceived as a risk factor for decline in renal function, especially in patients with preoperative renal dysfunction. There are few data on the effects of CPB on renal function in patients with mild preoperative renal dysfunction. The purpose of t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aen081
更新日期:2008-06-01 00:00:00
abstract::Dose-duration relationships for vecuronium were determined and the duration of action produced by vecuronium 0.3 mg kg-1 shown to equal that of pancuronium 0.1 mg kg-1. Using these doses, the neuromuscular blocking properties and cardiovascular effects of the two drugs were compared. With large dose administration of ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/61.2.180
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:Anaesthetic preconditioning (A_PreC) and postconditioning (A_PostC) both provide protection against ischaemia-reperfusion in the heart. However, post-ischaemic gene responses may differ between the two therapeutic strategies. METHODS:Isolated perfused rat hearts were exposed to 40 min test ischaemia followe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei155
更新日期:2005-08-01 00:00:00
abstract::Volume loading with crystalloid solution results in more pronounced haemodilution in patients who develop arterial hypotension during induction of extradural anaesthesia than in those who remain normotensive. The aim of this study was to describe the time course of this increase in haemodilution. Heart rate, systolic ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.2.223
更新日期:1996-08-01 00:00:00
abstract::The results of the ventilatory management of babies, obtained in the first 3 years of a neonatal surgical intensive care unit, are assessed. Overall mortality figures and detailed examination of the cause of death in individual diagnostic groups support a selective approach to intermittent positive pressure ventilatio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.3.273
更新日期:1980-03-01 00:00:00
abstract::The analgesic effects and bioavailability of a slow-release preparation of morphine (Duromorph) were studied in 12 patients with acute postoperative pain. Duromorph produced significant analgesia within 1-2 h of administration i.m., and there was a progressive decrease in the mean pain score for at least 8 h. None of ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.10.949
更新日期:1985-10-01 00:00:00
abstract::As the route of breathing and use of airway apparatus such as mask, mouthpiece and noseclip can alter breathing pattern, this study has used the helium dilution method to estimate the effects of mouthpiece and mask breathing on functional residual capacity (FRC) in the supine position, and the change in FRC that occur...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/76.4.560
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:As 6% hydroxyethyl starch (HES) 130/0.40 or 130/0.42 can originate from different vegetable sources, they might have different clinical effects. The purpose of this prospective, randomized, double-blind controlled trial was to compare two balanced tetrastarch solutions, one maize-derived and one potato-deriv...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aew249
更新日期:2016-10-01 00:00:00
abstract::We have used the technique of double-blind sequential allocation to quantify the minimum local analgesic concentration (MLAC) of extradural bupivacaine for women in early (median cervical dilatation 2 cm) and late (median cervical dilatation 5 cm) labour. The first bolus was 20 ml of the bupivacaine test solution. The...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/80.1.11
更新日期:1998-01-01 00:00:00
abstract::Protein kinase C (PKC) is a key regulatory enzyme that has been implicated as a molecular target for the action of general anaesthetics. We have determined the effects of halothane on the translocation and down-regulation of conventional PKC (cPKC) by analysing the subcellular distribution of PKC activity, [3H]phorbol...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.2.189
更新日期:1997-02-01 00:00:00
abstract:Background:Cognitive aids improve the technical performance of individuals and teams dealing with high-stakes crises. Hand-held electronic cognitive aids have rarely been investigated. A randomized controlled trial was conducted to investigate the effects of a smartphone application, named MAX (for Medical Assistance e...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aex256
更新日期:2017-11-01 00:00:00
abstract::Metoclopramide hastens emptying of the stomach. Since it may be given to patients before operation, the sedative and toxic effects of 10- and 20-mg does given i.m. were studied in patients and student volunteers. Saline and diazepam 10 mg were used as placebo and reference drugs. Neither dose of metoclopramide had as ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/46.7.509
更新日期:1974-07-01 00:00:00
abstract::Progressive obstruction of an axillary vein following an axillary approach to brachial plexus blockade is described. At surgical exploration, the axillary vein was narrowed with an aneurysm of its wall. It is likely that, during the performance of the block, the needle penetrated the adventitia of the vein, causing a ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.9.1051
更新日期:1984-09-01 00:00:00
abstract::The fresh gas flow rate necessary to prevent rebreathing in T-piece anaesthesia is well established at twice total ventilation. The minimum reservoir volume to avoid air dilution of anaesthetic gases in the alveolus at this flow rate is, however, undecided. A lung model was constructed to represent spontaneous respira...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.8.803
更新日期:1985-08-01 00:00:00
abstract::The effect of pretreatment with suxamethonium, gallamine or pancuronium on suxamethonium-induced fasciculations and myalgia was studied in a controlled, randomized and double-blind clinical trial. Both fasciculations and myalgia were assessed on a four-point rating scale. There was no significant correlation between f...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/60.4.367
更新日期:1988-03-01 00:00:00
abstract::In theory, setting an infrared multi-gas analyser to measure a volatile anaesthetic different from that in the sampled gas mixture may cause interference with carbon dioxide and nitrous oxide readings. The theory was investigated during evaluation of the Dräger Cicero EM anaesthetic workstation for the Medical Devices...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.5.737
更新日期:1996-05-01 00:00:00
abstract::Blood samples were obtained from a radial artery cannula in a 60-yr-old man during coronary artery surgery. Serum potassium concentrations of 9.3, 8.4, and 7.4 mmol litre(-1) were obtained. A simultaneous venous blood sample gave a serum potassium concentration of 4.4 mmol litre(-1). The ECG was unchanged. After the a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh199
更新日期:2004-09-01 00:00:00
abstract::Atropine and glycopyrronium are frequently used for premedication to reduce oral and respiratory secretions and prevent bradycardia. Glycopyrronium is said to have similar antisialagogue effects, but is less likely to cause significant tachycardia than atropine. Different antimuscarinic receptor selectivity patterns c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.5.549
更新日期:1995-05-01 00:00:00
abstract::In order to evaluate simple means of determining the rate of recovery after general anaesthesia, the usefulness of the critical flicker fusion threshold test, the Maddox wing apparatus and the visual analogue scale were compared. The postanaesthetic recovery score was used as a reference. Two patient groups (n = 15 in...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/59.8.978
更新日期:1987-08-01 00:00:00
abstract::We have compared, in a double-blind study, the efficacy of flumazenil with that of aminophylline in antagonizing the effects of midazolam in 60 patients (ASA I-II, mean age 66 yr) undergoing transurethral resection of prostate under spinal anaesthesia. All patients received midazolam 0.075 mg kg-1 i.v. and the test dr...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/66.5.591
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Psychological factors are thought to drive inter-patient variations in anaesthetic and analgesic requirements. This cross-sectional study investigated whether preoperative psychological factors can predict anaesthetic requirements and postoperative pain. METHODS:Before total thyroidectomy, 100 consecutive w...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer305
更新日期:2012-01-01 00:00:00