Abstract:
BACKGROUND:The pathophysiology of the serotoninergic system in malignant hyperthermia (MH) is not completely understood. The serotonin-2 (5HT(2A)) receptor agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane hydrochloride (DOI) induces typical MH symptoms, including skeletal muscle rigidity, an increase in body temperature, hyperventilation and acidosis in conscious MH-susceptible (MHS) pigs. Whether these symptoms are directly generated in skeletal muscle, result from central serotonergic overstimulation or from a porcine stress syndrome remains unresolved. In this study the in vivo effects of DOI on anaesthetized (and thus stress-protected) MHS and MH-normal (MHN) pigs were investigated. METHODS:and results. DOI 1 mg kg(-1) was administered three times at 40-min intervals to five MHS and five MHN anaesthetized pigs. Body temperature, heart rate, muscle tone, arterial carbon dioxide pressure (Pa(CO(2))), pH and creatine kinase concentrations were measured. The clinical occurrence of MH was defined by Pa(CO(2)) above 70 mm Hg and an increase in body temperature of more than 2 degrees C. Intragroup differences were analysed with the Friedman test as an overall non-parametric ANOVA and, in case of significance, with the Wilcoxon test. Intergroup comparisons were performed with the Mann-Whitney U-test (statistical significance P<0.05). MHS and MHN pigs developed muscle fasciculations, significant increases in body temperature and Pa(CO(2)) and a significant decrease in pH after the administration of DOI. These changes were comparable in both groups until the third dose of DOI, when in MHS pigs heart rate and Pa(CO(2)) rose significantly and pH fell significantly compared with MHN pigs. All MHS pigs fulfilled the MH criteria. Body temperature increased by more than 2 degrees C in all MHN pigs and Pa(CO(2)) exceeded 70 mm Hg in two. Thus, two MHN pigs fulfilled the criteria of MH. CONCLUSIONS:The comparability of the clinical presentation following DOI administration in MHS and MHN animals and the order of the development of MH-like symptoms favour the hypothesis of a central serotonergic overstimulation, leading to a serotonin syndrome.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Gerbershagen MU,Wappler F,Fiege M,Kolodzie K,Weisshorn R,Szafarczyk W,Kudlik C,Schulte Am Esch Jdoi
10.1093/bja/aeg172subject
Has Abstractpub_date
2003-08-01 00:00:00pages
281-4issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(17)36760-0journal_volume
91pub_type
杂志文章abstract::Perioperative risk of death after general surgery is quoted as overall less than 1%. However, each individual's risk varies widely according to many identified factors with some having a significantly increased risk of a worse outcome. The observation that manipulating and targeting certain physiological parameters in...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/ael102
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Better education of clinicians is expected to enhance patient safety. An important component of education is adherence to standard protocols, which are mainly available in written form. Believing in the potential power of videos, we hypothesized that the introduction of an educational video, based on an inst...
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abstract:BACKGROUND:Cardiac output (CO) monitoring is helpful in the assessment of critically ill pregnant women, but invasive monitors are often unsuitable for use. We aimed to measure agreement between the non-invasive ultrasound cardiac output monitor (USCOM) and three-dimensional transthoracic echocardiography (3D-TTE) in p...
journal_title:British journal of anaesthesia
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doi:10.1093/bja/aeu162
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abstract:BACKGROUND:Transitions into and out of the anaesthetised state exhibit resistance to state transitions known as neural inertia. As a consequence, emergence from anaesthesia occurs at a consistently lower anaesthetic concentration than induction. Motivated by stochastic switching between discrete activity patterns obser...
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更新日期:2018-07-01 00:00:00
abstract::Intraoperative awareness, with or without recall, continues to be a topic of clinical significance and neurobiological interest. In this article, we review evidence pertaining to the incidence, sequelae, and prevention of intraoperative awareness. We also assess which aspects of the complication are well understood (i...
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更新日期:2015-07-01 00:00:00
abstract::It is known that propofol can have effects on atrioventricular node conduction. We report a case where administration of propofol was associated with termination of supraventricular tachycardia. Although a similar phenomenon has been reported in children, this is the first such case in an adult. ...
journal_title:British journal of anaesthesia
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doi:
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journal_title:British journal of anaesthesia
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更新日期:1993-09-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
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更新日期:1992-02-01 00:00:00
abstract::This study has examined the effect of hydration on immediate recovery from anaesthesia in two groups of 15 patients undergoing therapeutic abortion. A standard anaesthetic technique was administered. Patients in group I received no preoperative fluid; those in group II received, before anaesthesia, 20 ml kg-1 of 4% gl...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
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更新日期:1992-06-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1989-02-01 00:00:00
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journal_title:British journal of anaesthesia
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更新日期:2005-12-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem267
更新日期:2007-12-01 00:00:00
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更新日期:1976-03-01 00:00:00
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doi:10.1093/bja/aei108
更新日期:2005-05-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Tetrodotoxin (TTX) is a powerful sodium channel blocker extracted from the puffer fish. The analgesic effects of TTX were investigated in different animal pain models. METHODS:Wistar rats were submitted to the formalin test and to partial ligation of the sciatic nerve (Seltzer's model). Swiss Webster mice w...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael096
更新日期:2006-06-01 00:00:00
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doi:10.1093/bja/64.1.77
更新日期:1990-01-01 00:00:00
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更新日期:1987-02-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/70.5.579
更新日期:1993-05-01 00:00:00
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更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:None of the currently available hypnosis monitoring systems have evaluated balanced xenon anaesthesia. We investigated the performance of the bispectral index (BIS) and the composite A-line autoregressive index (cAAI) while comparing balanced xenon with sevoflurane anaesthesia. METHODS:Sixty patients underg...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Forty-eight ASA I-II patients undergoing total abdominal hysterectomy (TAH) were studied in a double blind, randomized placebo controlled trial of parecoxib for postoperative analgesia. METHODS:All patients were given propofol 2-4 mg kg(-1) i.v., a non-depolarizing muscle relaxant, morphine 10 mg i.v. and p...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/bja/aer158
更新日期:2011-09-01 00:00:00
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journal_title:British journal of anaesthesia
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doi:10.1093/bja/aew247
更新日期:2016-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2017-09-01 00:00:00