Abstract:
BACKGROUND:Signalling of several G-protein-coupled receptors of the Gq/11 family is time-dependently inhibited by local anaesthetics (LAs). Since LA-induced modulation of muscarinic m1 and m3 receptor function may explain their beneficial effects in clinical practice, such as decreased postoperative cognitive dysfunction or less bronchoconstriction, we studied how prolonged exposure affects muscarinic signalling (Wang D, Wu X, Li J, Xiao F, Liu X, Meng M. The effect of lidocaine on early postoperative cognitive dysfunction after coronary artery bypass surgery. Anesth Analg 2002; 95: 1134-41; Groeben H, Silvanus MT, Beste M, Peters J. Combined lidocaine and salbutamol inhalation for airway anesthesia markedly protects against reflex bronchoconstriction. Chest 2000; 118: 509-15). METHODS:A two-electrode voltage clamp was used to assess the effects of lidocaine or its permanently charged analogue QX314 on recombinantly expressed m1 and m3 receptors in Xenopus oocytes. Antisense knock-down of functional Gαq-protein and inhibition of protein kinase C (PKC) served to define mechanisms and sites of action. RESULTS:Lidocaine affected muscarinic signalling in a biphasic way: an initial decrease in methylcholine bromide-elicited m1 and m3 responses after 30 min, followed by a significant increase in muscarinic responses after 8 h. Intracellularly injected QX314 time-dependently inhibited muscarinic signalling, but had no effect in Gαq-depleted oocytes. PKC-antagonism enhanced m1 and m3 signalling, but completely abolished the LA-induced increase in muscarinic responses, unmasking an underlying time-dependent inhibition of m1 and m3 responses after 8 h. CONCLUSIONS:Lidocaine modulates muscarinic m1 and m3 receptors in a time- and Gαq-dependent manner, but this is masked by enhanced PKC activity. The biphasic time course may be due to interactions of LAs with an extracellular receptor domain, modulated by PKC activity. Prolonged exposure to LAs may not benefit pulmonary function, but may positively affect postoperative cognitive function.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Picardi S,Stevens MF,Hahnenkamp K,Durieux ME,Lirk P,Hollmann MWdoi
10.1093/bja/aet299subject
Has Abstractpub_date
2014-02-01 00:00:00pages
370-9issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(17)31928-1journal_volume
112pub_type
杂志文章abstract::Eighteen patients were studied, during operations under subarachnoid or extradural anaesthesia combined with general anaesthesia, to assess the influence of occlusion of inspiration on the duration of inspiration, and the likelihood of a relationship between lung volume and duration of inspiration. Ten patients breath...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.3.215
更新日期:1984-03-01 00:00:00
abstract::An analysis of neuromuscular transmission has been made in phrenic nerve/diaphragm preparations from male rats aged 30 days or 110 days. The amplitude of miniature end-plate potentials was found to decrease with age, being 0.969 +/- SEM 0.058 mV at 30 days and 0.510 +/- SEM 0.031 mV at 110 days. Over the same period, ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.3.217
更新日期:1977-03-01 00:00:00
abstract::A series of 443 spinal anaesthetics is described. The procedures included operative vaginal delivery, removal of retained placenta and a miscellaneous group common to most obstetric units. Failure to provide effective relief of pain occurred in 5.2% of patients. There was one potentially serious complication, but with...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.6.531
更新日期:1979-06-01 00:00:00
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 tempe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg172
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:In a prospective, randomized, double-blind, placebo-controlled trial, we investigated the effect of adding meperidine 10 mg to intrathecal bupivacaine on the duration of early postoperative analgesia in 40 patients having elective Caesarean section under spinal anaesthesia. METHODS:Patients received intrath...
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/88.3.379
更新日期:2002-03-01 00:00:00
abstract::We describe a scavenging device, primarily for use during inhalation induction of anaesthesia in children; it was designed to optimize the often conflicting requirements of clinical acceptability and adequate gas collection. The performance was assessed in three ways. The device reduced the nitrous oxide concentration...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.1.117
更新日期:1990-01-01 00:00:00
abstract::The effects of laudanosine, a metabolite of atracurium, on the behaviour of conscious mice, rats and dogs, and on cardiovascular function in conscious and anaesthetized dogs have been evaluated: EEG studies were performed in anaesthetized dogs. In mice and rats, i.v. bolus doses of laudanosine 10-20 mg kg-1, caused co...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.2.218
更新日期:1987-02-01 00:00:00
abstract::The 119 patients who had undergone previous Caesarean section lumbar extradural block was administered to 77 (65%); the other 42 (35%) received analgesia with ketobemidone 0.8-1.0 ml i.m. or nitrous oxide in oxygen intermittently, or both. Controlled i.v. infusion of oxytocin for induction or acceleration of labour wa...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.8.827
更新日期:1980-08-01 00:00:00
abstract::Fires and explosions have occurred in the operating theatre for many years. Flammable inhalation anaesthetic agents were responsible for many incidents in the past, but these are no longer available in many countries. Other causes of fires and explosions still exist in the operating theatre and, from time to time, res...
journal_title:British journal of anaesthesia
pub_type: 历史文章,杂志文章
doi:10.1093/bja/73.6.847
更新日期:1994-12-01 00:00:00
abstract::We have examined the role of benzodiazepine receptors in nitrous oxide-induced neuronal depression in rats. The changes in neuronal excitability induced by nitrous oxide and the benzodiazepine inverse agonist, Ro15-4513, were monitored by measurement of visual evoked potentials (VEP). Administration of Ro15-4513 10 mg...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.4.522
更新日期:1996-10-01 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...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aev034
更新日期:2015-07-01 00:00:00
abstract::Patients with renal failure and undergoing a cadaver renal transplant were found to have plasma concentrations of laudanosine, following the administration of a single bolus dose of atracurium 0.5 mg kg-1, higher than those found in patients without renal failure. Since laudanosine is a known central nervous system st...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.11.1049
更新日期:1985-11-01 00:00:00
abstract::This study was designed to investigate if propofol produced cardiovascular effects by direct actions or by indirect actions secondary to depression of the central nervous system. Experiments were performed on chloralose anaesthetized dogs in which all neurogenic cardiovascular reflexes were abolished by bilateral vago...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/63.1.87
更新日期:1989-07-01 00:00:00
abstract::In a random, double-blind crossover trial using an ischaemic limb pain model we have assessed the speed of onset of analgesia after an i.v. bolus of equipotent doses of diamorphine and morphine in 12 healthy male volunteers. Pain and its subsequent relief were assessed by means of a visual analogue scale. Two of the s...
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/66.6.656
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:Blood flow patterns are important modifiers of platelet interactions with plasma coagulation factors. However, it is not feasible to evaluate rheological effects of haemodilution on coagulation using conventional coagulation testing. METHODS:We evaluated thrombus formation with a microchip-based flow-chambe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet229
更新日期:2013-12-01 00:00:00
abstract::We have compared mivacurium and succinylcholine in 27 paediatric patients with mild (Child's A) to moderate (Child's B) liver disease undergoing oesophagogastroduodenoscopy (OGD) and injection of oesophageal varices, with 10 healthy children receiving mivacurium for ENT procedures. With mivacurium 0.2 mg kg-1, the sev...
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/81.3.463
更新日期:1998-09-01 00:00:00
abstract::A patient with a foreign body penetrating the neck and chest was found to have physical signs which were consistent with serious tracheal injury and included a large movement of air through the lower part of the neck. The subsequent management of the patient and the difficult problem of securing an airway are describe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/66.6.724
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:The ilioinguinal/iliohypogastric nerve block is a popular regional anaesthetic technique for children undergoing inguinal surgery. The success rate is only 70-80% and complications may occur. A prospective randomized double-blinded study was designed to compare the use of ultrasonography with the conventiona...
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/aei157
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Intraneural injection of local anaesthetic agents carries a risk of neurological complications. Early detection of intraneural needle-tip position is very important in the initial phase of injection. Ultrasound (US) characteristics for real-time detection of intraneural injections have been described, but on...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes208
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Pressures (Pe) exerted by bronchial blockers on the inner wall of the bronchi may cause mucosal ischaemia. Our aims were as follows: (i) to compare the intracuff pressure (Pi) and Pe exerted by commercially available bronchial blockers in an in vitro and an ex vivo model; (ii) to investigate the influence of...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew120
更新日期:2016-09-01 00:00:00
abstract::We have investigated whether nitrous oxide antagonizes or augments the CNS stimulant action of laudanosine in mice by comparing the mean convulsive doses (CD50 (SE] of a control group and those following pretreatment with 65% nitrous oxide in oxygen for 20 and 180 min. Nitrous oxide significantly increased CD50 from 4...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.5.704
更新日期:1990-11-01 00:00:00
abstract::We have assessed tracheal intubating conditions in 60 ASA I or II patients after induction of anaesthesia with propofol 2.5 mg kg-1 and alfentanil 10 or 20 micrograms kg-1 with or without i.v. lignocaine 1 mg kg-1. No neuromuscular blocking agents were administered. Patients were allocated randomly to four groups: gro...
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/70.2.163
更新日期:1993-02-01 00:00:00
abstract::We have compared the ability of naïve intubators to intubate the trachea using a laryngoscope and an intubating laryngeal mask airway (ILMA) after receiving basic training, in a randomized, prospective, crossover study in 60 patients. Ventilation of the lungs via the ILMA was also compared with ventilation with a face...
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/83.4.615
更新日期:1999-10-01 00:00:00
abstract::We have compared iontophoretically and locally applied lidocaine for relief of pain on propofol injection. Pain was assessed on insertion of a 20-gauge i.v. cannula and at 10-s intervals for 30 s after injection of propofol. Pain scores on cannulation were significantly less in the iontophoresis group (median 1.1) tha...
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/82.3.432
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Although opioids are widely used as analgesics in general anaesthesia, they have unpleasant side-effects and can delay postoperative recovery. Acupuncture and related techniques are effective for acute and chronic pain, and reduces some side-effects. We assessed the effect of transcutaneous electric acupoint...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeu001
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Thermal, mechanical, and electrical stimuli are often used in acute pain studies and cause qualitatively different pain sensations. Yet, the comparative electroencephalogram (EEG) changes caused by these stimuli have not been studied. We hypothesized that because these stimuli cause different pain sensations...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael377
更新日期:2007-03-01 00:00:00
abstract::The concentrations of volatile hydrocarbons were studied in breath samples from patients before and after anaesthesia. In patients to whom halothane was administered, there was a significant increase in the concentration of isobutene (from 0.43 +/- 0.09 to 4.66 +/- 2.22 nmol litre-1). There was no change in the concen...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.10.989
更新日期:1980-10-01 00:00:00
abstract:BACKGROUND:State entropy (SE) is a newly available monitor for depth of anaesthesia. We investigated whether the relationship between predicted effect-site propofol concentration and Bispectral Index (BIS) and SE values is useful for predicting loss of verbal contact and loss of consciousness during steady-state condit...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei075
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:During normothermic cardiopulmonary bypass (CPB), the effect on propofol pharmacokinetics of changes in its binding to plasma proteins is consistent with the predictions of the well-stirred model of hepatic elimination for nonrestrictively cleared drug. However, whether changes in binding lead to clinically ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aei293
更新日期:2006-02-01 00:00:00
abstract::Three formulations of etomidate were evaluated in unpremedicated patients undergoing minor gynaecological procedures. There was a high frequency of pain on injection (up to 50%) and excitatory phenomena (up to 95%) with all formulations. The frequency of excitatory phenomena was significantly greater than that after m...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/50.9.925
更新日期:1978-09-01 00:00:00