Halothane and Isoflurane Differentially Affect the Regulation of Dopamine and Gamma-aminobutyric Acid Release Mediated by Presynaptic Acetylcholine Receptors in the Rat Striatum

Background: General anesthetics are thought to produce their hypnotic effects mainly by acting at ligand-gated ionic channels in the central nervous system (CNS). Although it is well established that volatile anesthetics significantly modify the activity of the acetylcholine nicotinic receptors of the neuromuscular junction, little is known about their actions on the acetylcholine receptors in the CNS. In this study, the effects of halothane and isoflurane on the regulation of dopamine (DA) (gamma-aminobutyric acid [GABA]) depolarization-evoked release mediated by nicotinic (muscarinic) presynaptic receptors were studied in the rat striatum.

Methods: Assay for GABA (dopamine) release consisted of3 H-GABA (sup 3 H-DA)-preloaded synaptosomes with artificial cerebrospinal fluid (0.5 ml/min, 37 degrees Celsius) and measuring the radioactivity obtained from 1-min fractions for 18 min, first in the absence of any treatment (spontaneous release, 8 min), then in the presence of depolarizing agents combined with vaporized halothane and isoflurane (0.5-5%, 5 min), and finally with no pharmacologic stimulation (5 min). The depolarizing agents were potassium chloride (KCl; 9 mM) alone or with acetylcholine (10 sup -6 - 10 sup -4 M) and/or atropine (10 sup -5 M) for experiments with3 H-GABA, and KCl (15 mM) and nicotine (10 sup -7 - 5 x 10 sup -4 M) alone or with mecamylamine (10 sup -5 M) for experiments with3 H-DA.

Results: Potassium chloride induced a significant, Ca2+ -dependent release of both3 H-GABA and3 H-DA. Nicotine produced a concentration-related, mecamylamine-sensitive3 H-DA release that was significantly attenuated by nicotine (10 sup -7 M) preincubation. Acetylcholine elicited a dose-dependent, atropine-sensitive reduction of the KCl-evoked3 H-GABA release. Halothane and isoflurane significantly decreased the nicotine-evoked3 H-DA release but had only limited depressant effects on the KCl-stimulated3 H-DA and no action on the KCl-induced3 H-GABA release. The effects of acetylcholine on3 H-GABA release were reversed by halothane but not by isoflurane.     

Effects of Propofol on Sodium Channel-dependent Sodium Influx and Glutamate Release in Rat Cerebrocortical Synaptosomes

Background: Previous electrophysiologic studies have implicated voltage-dependent Na+ channels as a molecular site of action for propofol. This study considered the effects of propofol on Na+ channel-mediated Na+ influx and neurotransmitter release in rat brain synaptosomes (isolated presynaptic nerve terminals).

Methods: Purified cerebrocortical synaptosomes from adult rats were used to determine the effects of propofol on Na+ influx through voltage-dependent Na+ channels (measured using22 Na+) and intracellular [Na+] (measured by ion-specific spectrofluorimetry). For comparison, the effects of propofol on synaptosomal glutamate release evoked by 4-aminopyridine (Na+ channel dependent), veratridine (Na (+) channel dependent), and KCl (Na+ channel independent) were studied using enzyme-coupled fluorimetry.

Results: Propofol inhibited veratridine-evoked22 Na+ influx (inhibitory concentration of 50% [IC50] = 46 micro Meter; 8.9 micro Meter free) and changes in intracellular [Na+] (IC50 = 13 micro Meter; 6.3 micro Meter free) in synaptosomes in a dose-dependent manner. Propofol also inhibited 4-aminopyridine-evoked (IC50 = 39 micro Meter; 19 micro Meter free) and veratridine (20 micro Meter)-evoked (IC (50) = 30 micro Meter; 14 micro Meter free), but not KCl-evoked (up to 100 micro Meter) glutamate release from synaptosomes.     

Riluzole Anesthesia: Use-Dependent Block of Presynaptic Glutamate Fibers

Background: Riluzole (RP 54274) is an experimental benzothiazole with anesthetic properties, but little is known about its synaptic or cellular actions.

Methods: The authors investigated riluzole effects on synaptic response of CA 1 pyramidal neurons in rat hippocampal brain slices. Electrophysiologic recordings of population spikes (PS), excitatory postsynaptic potentials (EPSP), and fiber volleys were studied. Paired pulse stimulation (120 ms interpulse interval) was used to measure effects on gamma-amino butyric acid (GABA)-mediated synaptic inhibition, and stimulus trains (33 Hz) were used to test for use-dependent effects.

Results: Synaptically evoked PS discharge was blocked in a concentration-dependent manner by riluzole (2.0-20 micro Meter), similar to effects produced by other anesthetics. Paired pulse inhibition was not altered by riluzole. In contrast, 20 micro Meter thiopental produced a marked increase in paired pulse inhibition. Riluzole (5.0 micro Meter) produced a 46.6 plus/minus 19.8% depression of glutamate-mediated EPSPs, which could account for most of the depression of PS discharge (54.2 plus/minus 12.6%) produced by this concentration. Riluzole produced a 36 plus/minus 17% depression of fiver volley amplitudes, which, based on input/output analysis, could completely account for the depression of EPSPs. The depression of fiber volley amplitudes showed a marked use-dependence; the second and subsequent action potentials in a train were progressively depressed by riluzole to a greater extent than the first action potential.     

Anesthetics Affect the Uptake but Not the Depolarization-evoked Release of GABA in Rat Striatal Synaptosomes

Background: Numerous classes of anesthetic agents have been shown to enhance the effects mediated by the postsynaptic gamma-aminobutyric acid A (GABAA) receptor-coupled chloride channel in the mammalian central nervous system. However, presynaptic actions of anesthetics potentially relevant to clinical anesthesia remain to be clarified. Therefore, in this study, the effects of intravenous and volatile anesthetics on both the uptake and the depolarization-evoked release of GABA in the rat stratum were investigated.

Methods: Assay for specific GABA uptake was performed by measuring the radioactivity incorporated in purified striatal synaptosomes incubated with3 H-GABA (20 nM, 5 min, 37 degrees Celsius) and increasing concentrations of anesthetics in either the presence or the absence of nipecotic acid (1 mM, a specific GABA uptake inhibitor). Assay for GABA release consisted of superfusing3 H-GABA preloaded synaptosomes with artificial cerebrospinal fluid (0.5 ml *symbol* min sup 1, 37 degrees Celsius) and measuring the radioactivity obtained from 0.5 ml fractions over 18 min, first in the absence of any treatment (spontaneous release, 8 min), then in the presence of either KCl alone (9 mM, 15 mM) or with various concentrations of anesthetics (5 min), and finally, with no pharmacologic stimulation (5 min). The following anesthetic agents were tested: propofol, etomidate, thiopental, ketamine, halothane, enflurane, isoflurane, and clonidine.

Results: More than 95% of3 H-GABA uptake was blocked by a 10 sup 3 -M concentration of nipecotic acid. Propofol, etomidate, thiopental, and ketamine induced a dose-related, reversible, noncompetitive, inhibition of3 H-GABA uptake: IC50 = 4.6 plus/minus 0.3 x 105 M, 5.8 plus/minus 0.3 x 10 sup -5 M, 2.1 plus/minus 0.4 x 10 sup -3 M, and 4.9 plus/minus 0.5 x 10 sup -4 M for propofol, etomidate, thiopental, and ketamine, respectively. Volatile agents and clonidine had no significant effect, even when used at concentrations greater than those used clinically. KCl application induced a significant, calcium-dependent, concentration-related, increase from basal3 H-GABA release, +34 + 10% (P < 0.01) and +61 plus/minus 13% (P < 0.001), respectively, for 9 mM and 15 mM KCl. The release of3 H-GABA elicited by KCl was not affected by any of the anesthetic agents tested.     

Ketamine Inhibits Glutamate-, N-Methyl-D-Aspartate-, and Quisqualate-stimulated cGMP Production in Cultured Cerebral Neurons

Background: Glutamatergic signaling has been linked to the recently discovered neurotransmitter/neuromodulator nitric oxide (NO), and several classes of anesthetics block some step in glutamatergic signaling. This study was designed to determine whether or not ketamine would prevent NO-dependent cGMP production stimulated by glutamate (GLU) and the GLU analogs NMDA, quisqualate (QUIS), and kainate (KAIN).

Methods: Primary cultures of cortical neurons and glia (prepared from 16-day gestational rat fetuses) were used after 12-16 days in culture. Reactions were carried out in magnesium-free buffer containing 100 micro Meter 3-isobutyl-l-methylxanthine, and cGMP content of cultures was used as a bioassay of NO production.

Results: Cyclic GMP production stimulated by sodium nitroprusside (100 micro Meter) occurred predominately in neurons and not in glia. Neurons were spontaneously active in these cultures; basal cGMP production was decreased by 50% in the presence of 1 micro Meter tetrodotoxin (TTX). Glutamate (100 micro Meter), NMDA (100 micro Meter), QUIS (300 micro Meter), and KAIN (100 micro Meter) each increased cGMP content of neuronal cultures. L-NMMA (100 micro Meter), a NO synthase inhibitor, prevented the stimulation of cGMP production by GLU or its analogs. Pretreatment with MK-801 (1 micro Meter) or ketamine (10-100 micro Meter) inhibited GLU-, NMDA-, and QUIS-stimulated cGMP production. Quisqualate-stimulated responses were the most sensitive to inhibition by ketamine and NMDA-stimulated responses were the least sensitive to inhibition. MK-801 and ketamine did not significantly inhibit KAIN-stimulated cGMP production. CNQX (10 micro meter) blocked KAIN-stimulated cGMP production only.     

Volatile Anesthetic Actions on Contractile Proteins in Membrane-permeabilized Small Mesenteric Arteries

Background: Volatile anesthetics have been shown to have vasodilating or vasoconstricting actions in vitro that may contribute to their cardiovascular effects in vivo. However, the precise mechanisms of these actions in vitro have not been fully elucidated. Moreover, there are no data regarding the mechanisms of volatile anesthetic action on small resistance arteries, which play a critical role in the regulation of blood pressure and blood flow.

Methods: With the use of isometric tension recording methods, volatile anesthetic actions were studied in intact and beta-escin-membrane-permeabilized smooth muscle strips from rat small mesenteric arteries. In experiments with intact muscle, the effects of halothane (0.25-5.0%), isoflurane (0.25-5.0%), and enflurane (0.25-5.0%) were investigated on high Potassium sup + -induced contractions at 22 degrees Celsius and 35 degrees Celsius. All experiments were performed on endothelium-denuded strips in the presence of 3 micro Meter guanethidine and 0.3 micro Meter tetrodotoxin to minimize the influence of nerve terminal activities. In experiments with membrane-permeabilized muscle, the effects of halothane (0.5-4.0%), isoflurane (0.5-4.0%), and enflurane (0.5-4.0%) on the half-maximal and maximal Calcium2+ -activated contractions were examined at 22 degrees Celsius in the presence of 0.3 micro Meter ionomycin to eliminate intracellular Calcium sup 2+ stores.

Results: In the high Potassium sup + -stimulated intact muscle, all three anesthetics generated transient contractions, which were followed by sustained vasorelaxation. The IC50 values for this vasorelaxing action of halothane, isoflurane, and enflurane were 0.47 vol% (0.27 mM), 0.66 vol% (0.32 mM), and 0.53 vol% (0.27 mM), respectively, at 22 degrees Celsius and were 3.36 vol% (0.99 mM), 3.07 vol% (0.69 mM), and 3.19 vol% (0.95 mM), respectively, at 35 degrees Celsius. Ryanodine (10 micro Meter) eliminated the anesthetic-induced contractions but had no significant effect on the anesthetic-induced vasorelaxation in the presence of high Potassium sup +. In addition, no significant differences were observed in the dose dependence of the direct vasodilating action among these anesthetics with or without ryanodine at either the low or the high temperature. However, significant differences were observed in the vasoconstricting actions among the anesthetics, and the order of potency was halothane > enflurane > isoflurane. The Calcium sup 2+ -tension relation in the membrane-permeabilized muscle yielded a half-maximal effective Calcium2+ concentration (EC50) of 2.02 micro Meter. Halothane modestly but significantly inhibited 3 micro Meter (approximately the EC50) and 30 micro Meter (maximal) Calcium sup 2+ -induced contractions. Enflurane slightly but significantly inhibited 3 micro Meter but not 30 micro Meter Calcium2+ contractions. Isoflurane did not significantly inhibit either 3 micro Meter or 30 micro Meter Calcium2+ contractions.     

Benzodiazepines Differentially Inhibit Phenylephrine-induced Calcium Oscillations in Pulmonary Artery Smooth Muscle Cells

Background: Modulation of intracellular free calcium is a critical determinant of vasomotor tone. The authors investigated the effects of three benzodiazepines on alpha-adrenergic-induced oscillations in intracellular free calcium in individual pulmonary artery smooth muscle cells.

Methods: Pulmonary artery smooth muscle cells were cultured from explants of canine intrapulmonary artery. Fura-2-loaded pulmonary artery smooth muscle cells were continuously superfused with phenylephrine (10 micro Meter) at 37 [degree sign] Celsius on the stage of an inverted fluorescence microscope. Intracellular free calcium was measured using a dual wavelength spectrofluorometer. After establishment of steady-state intracellular free calcium oscillations induced by phenylephrine, lorazepam, diazepam, or midazolam was added to the superfusate. The amplitude and frequency of the intracellular free calcium oscillations were compared before and after addition of each agent.

Results: Resting mean +/- SEM values of intracellular free calcium were 68 +/- 8 nM. Phenylephrine stimulated dose-dependent oscillations in intracellular free calcium, which reached a peak concentration of 676 +/- 35 nm and a frequency of 1.08 +/- 0.1 transients/min. Addition of lorazepam (1 micro Meter) inhibited (P < 0.05) the amplitude (591 +/- 32 nM) but not the frequency (0.97 +/- 0.1 transients/min) of the oscillations. Conversely, diazepam (1 micro Meter) decreased (P < 0.05) the frequency (0.79 +/- 0.1 transients/min) but not the amplitude (663 +/- 37 nM) of the oscillations. These effects were dose-dependent. In contrast, midazolam. (1-30 micro Meter) had no effect on the amplitude or frequency of intracellular free calcium oscillations. At concentrations higher than 100 micro Meter, however, all three benzodiazepines inhibited both the amplitude and frequency of the intracellular free calcium oscillations.     

The Relation between Cerebral Metabolic Rate and Ischemic Depolarization: A Comparison of the Effects of Hypothermia, Pentobarbital, and Isoflurane

Background: Reductions in cerebral metabolic rate may increase the brain's tolerance of ischemia. However, outcome studies suggest that reductions in cerebral metabolic rate produced by anesthetics and by hypothermia may not be equally efficacious. To examine this question, we measured the effects of hypothermia, pentobarbital, and isoflurane on the cerebral metabolic rate for glucose (CMRG) and on the time to the loss of normal membrane ion gradients (terminal ischemic depolarization) of the cortex during complete global ischemia.

Methods: As pericranial temperature was varied between 39 and 25 degrees Celsius in normocapnic halothane-anesthetized rats, CMRG (using14 Carbon-deoxyglucose) or the time to depolarization (using a glass microelectrode in the cortex) after a Potassium sup + -induced cardiac arrest was measured. In other studies, CMRG and depolarization times were measured in normothermic animals (37.7 plus/minus 0.2 degree Celsius) anesthetized with high-dose pentobarbital or isoflurane (both producing burst suppression on the electroencephalogram) or in halothane-anesthetized animals whose temperatures were reduced to 27.4 plus/minus 0.3 degree Celsius. These three states were designed to produce equivalent CMRG values.

Results: As temperature was reduced from 39 to 25 degrees Celsius, CMRG decreased from 66 to 21 micro Meter *symbol* 100 g sup -1 *symbol* min1 (Q10 = 2.30), and depolarization times increased from 76 to 326 s. In similarly anesthetized animals at approximately 27 degrees Celsius, CMRG was 32 plus/minus 4 micro Meter *symbol* 100 g sup -1 *symbol* min sup -1 (mean plus/minus SD), whereas in normothermic pentobarbital- and isoflurane-anesthetized rats, CMRG values were 33 plus/minus 3 and 37 plus/minus 4 micro Meter *symbol* 100 g1 *symbol* min sup -1, respectively (P = 0.072 by one-way analysis of variance). Despite these similar metabolic rates, the times to depolarization were markedly different: for hypothermia it was 253 plus/minus 29 s, for pentobarbital 109 plus/minus 24 s, and for isoflurane 130 plus/minus 28 s (P < 0.0001).     

Endothelium-independent Vasoconstricting and Vasodilating Actions of Halothane on Rat Mesenteric Resistance Blood Vessels

Background: Whether volatile anesthetics produce changes in vascular resistance and blood flow because of direct effects on vascular tissue is unclear. Direct vasoconstricting and vasodilating actions have been demonstrated in isolated conductance arteries in vitro, but there is little information regarding direct effects on the small vessels that mediate resistance and flow changes in vivo.

Methods: We investigated the actions of halothane on 50-200 micro Meter branches of the rat mesenteric artery that were cannulated and studied in vitro. The vessels were pressurized to 60 mmHg, and vascular dimensions were continuously monitored using a computer-based real-time image analysis system. The vessel bath was perfused with HCO3 -buffered saline (37 degrees Celsius) equilibrated with 95% Oxygen2 /5% CO2 (plus/minus halothane). The vascular endothelium was mechanically removed before cannulation in some vessels.

Results: In unstimulated vessels, halothane had a concentration-dependent vasoconstricting action (EC50 = 0.45 mM = 1.5 vol% at 37 degrees Celsius) that was largely transient and was similar to that produced by caffeine. Both halothane and caffeine constrictions were unaffected by bath [Calcium2+], nifedipine (1 micro Meter) or Cadmium2+ (100 micro Meter) and were abolished by ryanodine (10 micro Meter). In addition, caffeine responses were attenuated by halothane in a concentration-dependent manner (EC50 - 1.6 mM). In vessels preconstricted with KCl (40 mM) or phenylephrine (10 sup -6 M), halothane produced transient constriction followed by concentration-dependent vasodilation. Ryanodine, which abolished halothane constrictions, had little effect on the amplitude of KCl- or phenylephrine-induced constrictions or the vasodilating action of halothane. Removal of the endothelium likewise had little effect on the vasoconstricting or the vasodilating actions of halothane in unstimulated, KCl- or phenylephrine-constricted vessels. Halothane completely relaxed KCl and phenylephrine constrictions with EC50 values of 0.36 mM (1.2% at 37 degrees Celsius) and 0.75 mM (2.5%), respectively, in intact vessels before ryanodine; 0.25 mM (0.8%) and 0.59 mM (1.9%) in intact vessels after ryanodine; and 0.52 mM (1.7%) and 0.67 mM (2.2%) in endothelium-denuded vessels.     

The Effect of Thiopental and Propofol on NMDA- and AMPA-mediated Glutamate Excitotoxicity

Background: Glutamate excitotoxicity has been implicated as an important cause of ischemic, anoxic, epileptic, and traumatic neuronal damage. Glutamate receptor antagonists have been shown to reduce anoxic, ischemic, and epileptic damage. The effects of thiopental and propofol on N-methyl-D-aspartate (NMDA) and alpha-amino-3-hydroxy-5-methyl-4-isoxazole proprionate (AMPA)-induced neuronal damage were investigated in this study.

Methods: The Schaffer collateral pathway was stimulated, and a postsynaptic-evoked population spike was recorded from the CA1 pyramidal cell layer of rat hippocampal slices. The recovery of the population spike amplitude was an indicator of neuronal viability. The duration of NMDA (25 micro Meter) or AMPA (15 or 10 micro Meter) treatment was 10 min. Thiopental (600 micro Meter), propofol (112 micro Meter), or the vehicle was present 15 min before, during, and 10 min after the NMDA or AMPA treatment.

Results: Thiopental prolonged the time required to completely block the population spike after the addition of NMDA or AMPA. Thiopental improved the recovery of the population spike after 25 micro Meter NMDA (79% vs. 44%) and 15 micro Meter AMPA (50% vs. 15%). Propofol worsened the recovery of the population spike from NMDA-induced damage. The recovery was 8% with propofol compared with 40% with NMDA alone. Propofol did not significantly alter the AMPA-induced neuronal damage.     

Skin Blood Flow and Plasma Catecholamines during Removal of Pheochromocytoma

Background: Endothelium-derived hyperpolarizing factor is thought to be a cytochrome P450-derived arachidonic acid metabolite that hyperpolarizes vascular smooth muscle cells by opening Calcium2+ -activated Potassium sup + channels (K sup +Ca channels). In the rabbit carotid artery both volatile and intravenous anesthetics inhibit the acetylcholine-stimulated release of endothelium-derived hyperpolarizing factor. Because the release of this factor may help to maintain vascular tone in humans under conditions of a failing nitric oxide synthesis, e.g., in atherosclerosis, the effects of two intravenous anesthetics, thiopental and etomidate, on the endothelium-derived hyperpolarizing factor-mediated relaxant response to acetylcholine were investigated in human isolated renal artery segments.

Methods: The segments were suspended in Krebs-Henseleit solution (37 degrees C) containing the cyclooxygenase inhibitor diclofenac (1 micro Meter) and preconstricted with norepinephrine (6 micro Meter). Relaxations caused by acetylcholine (1 micro Meter) were compared in the presence and absence of the nitric oxide synthase inhibitor NG -nitro-L-arginine (0.1 mM) in control segments and in segments exposed to etomidate or thiopental (0.03-0.3 mM). In addition, the effects of the two anesthetics on the relaxant response to the nitric oxide donors glyceryl trinitrate (3 micro Meter) and sodium nitroprusside (0.1 micro Meter) were examined.

Results: The relaxant response to acetylcholine, which was resistant to both nitric oxide synthase and cyclooxygenase blockade, was markedly reduced by the K sup +Ca channel antagonist tetrabutyl ammonium (3 mM) and the cytochrome P450 inhibitor clotrimazole (30 micro Meter). Both etomidate and thiopental, at a concentration of 0.3 mM, selectively attenuated the relaxant response to acetylcholine in NG -nitro-L-arginine-treated segments, but did not affect relaxations elicited by glyceryl trinitrate or sodium nitroprusside.     

Neurophysiologic Actions and Neurological Consequences of Veratridine on the Rat Sciatic Nerve

Background: The quest for a drug that would provide analgesia with minimal motor deficiency, through the selective inhibition of impulses in small-diameter fibers, was brightened by a previous report of veratridine's C-fiber-selective actions on the isolated rabbit vagus nerve. The goal of the present research was to demonstrate the same actions on rat sciatic nerve in vitro and to observe the functionally differential blockade in the rat in vivo.

Methods: Sciatic nerves were removed from rats, mounted in a recording chamber, wherein a 1-cm length of the ensheathed nerve was superfused with the plant alkaloid veratridine (2 micro Meter) in bicarbonate-buffered Liley's solution, and the compound action potential (CAP) was stimulated supramaximally to give A- and C-fiber elevations. Onset, steady-state, and recovery from veratridine effects were assayed for a range of stimulus frequencies. Open-field behavior and quantitative neurological assessments of proprioception, motor function, and nociception were tested in 15 trained rats after injection near the sciatic nerve of 0.1 ml veratridine at 0.5, 0.7, and 1.0 mM each plus epinephrine (1:200,000).

Results: Veratridine inhibited the C-fiber component of the CAP in a frequency-dependent manner. At 0.1 Hz the CAP was 65% of the control amplitude, 50% at 0.5 Hz, and 40% at 5 Hz. A-fiber elevations were unattenuated at stimulus frequencies as high as 50 Hz. Steady-state inhibition was reached 5 min after drug administration, and recovery from the effects was 30% complete by 15 min of drug washout. Proprioception, measured as a "hopping" or "placing" reaction, was inhibited dose dependently by maximum degree and for durations of, respectively, 0.5 mM, 61%, 180 min; 0.7 mM, 100%, 360 min; and 1 mM, 100%, 420 min. Extensor postural thrust, as a measure of motor function, was inhibited by and for 0.5 mM, 77%, 240 min; 0.7 mM, 99%, 390 min; and 1 mM, 100%, 420 min. Analgesia, as a prolonged withdrawal latency to a noxious thermal stimulus, had the following profile: 0.5 mM, 10%, 30 min; 0.7 mM, 52%, 150 min; and 1 mM, 66%, 150 min.     

Multiple Mechanisms of Ketamine Blockade of N-methyl-D-aspartate Receptors

Background: The N-methyl-D-aspartate (NMDA) subtype of glutamate receptor is blocked by ketamine, and this action likely contributes to ketamine's anesthetic and analgesic properties. Previous studies suggest that ketamine occludes the open channel by binding to a site located within the channel pore. This hypothesis was examined by investigating the effects of ketamine on single-channel currents from NMDA receptors.

Methods: The cell-attached and outside-out configurations of the patch clamp technique were used to study NMDA-activated currents recorded from cultured mouse hippocampal neurons.

Results: In cell-attached patches, NMDA evoked currents that had an apparent mean open time (tauo) of 3.26 ms. The probability of at least one channel being open (Po') was 0.058. The addition of ketamine (0.1 micro Meter or 1 micro Meter) to the pipette solution decreased Po' to 53% and 24% of control values, respectively. At 1 micro Meter ketamine, this reduction was due to a decrease in both the frequency of channel opening and the mean open time (44% and 68% of control values, respectively). Ketamine did not influence channel conductance and no new components were required to fit the open- or closed-duration distributions. Ketamine (50 micro Meter), applied outside the recording pipette, reduced the opening frequency of channels recorded in the cell-attached configuration. This observation suggests that ketamine gained access to a binding site by diffusing across the hydrophobic cell membrane. In outside-out patches, ketamine potency was lower than that observed in cell-attached patches: 1 micro Meter and 10 micro Meter ketamine reduced Po' to 63% and 34% of control values, respectively, and this reduction was due primarily to a decrease in the frequency of channel opening with little change in mean open time.     

Hypothermic Modulation of Cerebral Ischemic Injury during Cardiopulmonary Bypass in Pigs

Background: The aim of this study was to determine whether progressive levels of hypothermia (37, 34, 31, or 28 [degree sign] Celsius) during cardiopulmonary bypass (CPB) in pigs reduce the physiologic and metabolic consequences of global cerebral ischemia.

Methods: Sagittal sinus and cortical microdialysis catheters were inserted into anesthetized pigs. Animals were placed on CPB and randomly assigned to 37 [degree sign] Celsius (n = 10), 34 [degree sign] Celsius (n = 10), 31 [degree sign] Celsius (n = 11), or 28 [degree sign] Celsius (n = 10) management. Next 20 min of global cerebral ischemia was produced by temporarily ligating the innominate and left subclavian arteries, followed by reperfusion, rewarming, and termination of CPB. Cerebral oxygen metabolism (CMRO2) was calculated by cerebral blood flow (radioactive microspheres) and arteriovenous oxygen content gradient. Cortical excitatory amino acids (EAA) by microdialysis were measured using high-performance liquid chromatography. Electroencephalographic (EEG) signals were graded by observers blinded to the protocol. After CPB, cerebrospinal fluid was sampled to test for S-100 protein and the cerebral cortex was biopsied.

Results: Cerebral oxygen metabolism increased after rewarming from 28 [degree sign] Celsius, 31 [degree sign] Celsius, and 34 [degree sign] Celsius CPB but not in the 37 [degree sign] animals; CMRO2, remained lower with 37 [degree sign] Celsius (1.8 +/- 0.2 ml [center dot] min sup -1 [center dot] 100 g sup -1) than with 28 [degree sign] Celsius (3.1 +/- 0.1 ml [center dot] min sup -1 [center dot] 100 g sup -1; P < 0.05). The EEG scores after CPB were depressed in all groups and remained significantly lower in the 37 [degree sign] Celsius animals. With 28 [degree sign] Celsius and 31 [degree sign] Celsius CPB, EAA concentrations did not change. In contrast, glutamate increased by sixfold during ischemia at 37 [degree sign] Celsius and remained significantly greater during reperfusion in the 34 [degree sign] Celsius and 37 [degree sign] Celsius groups. Cortical biopsy specimens showed no intergroup differences in energy metabolites except two to three times greater brain lactate in the 37 [degree sign] Celsius animals. S-100 protein in cerebrospinal fluid was greater in the 37 [degree sign] Celsius (6 +/- 0.9 micro gram/l) and 34 [degree sign] Celsius (3.5 +/- 0.5 micro gram/l) groups than the 31 [degree sign] Celsius (1.9 +/- 0.1 micro gram/l) and 28 [degree sign] Celsius (1.7 +/- 0.2 micro gram/l) animals.     

Intravenous Anesthetics Attenuate Phenylephrine-induced Calcium Oscillations in Individual Pulmonary Artery Smooth Muscle Cells

Background: The authors investigated the effects of intravenous anesthetics on alpha-adrenergic-induced oscillations in intracellular free calcium concentration ([Ca2+]i) in individual pulmonary artery smooth muscle cells (PASMCs).

Methods: PASMCs were cultured from explants of canine intrapulmonary artery. Fura-2-loaded PASMCs were continuously superfused with phenylephrine (10 micro Meter) at 37 [degree sign] Celsius on the stage of an inverted fluorescence microscope. Measurement of [Ca2+] sub i was via a dual wavelength spectrofluorometer. Intravenous anesthetics were added to the superfusate to assess their effects on the phenylephrine-induced [Ca2+]i oscillations.

Results: Resting [Ca2+]i was 103 +/- 6 nM. Phenylephrine stimulated [Ca2+]i oscillations, reaching a peak concentration of 632 +/- 20 nM and a frequency of 1.53 +/- 0.14 transients/min. The effects of phenylephrine were dose-dependent. The effects of intravenous anesthetics on phenylephrine-induced [Ca2+]i oscillations were dose-dependent. Ketamine (100 micro Meter) reduced the amplitude (221 +/- 22 nM) but not the frequency (1.48 +/- 0.11/min) of the oscillations, whereas thiopental (100 micro Meter) decreased the amplitude (270 +/- 20 nM) and the frequency (1.04 +/- 0.10/min). Propofol (100 micro Meter) and the Intralipid[registered sign] vehicle inhibited the amplitude (274 +/- 11 nM) but not the frequency (1.39 +/- 0.11/min) of the oscillations. The effects of ketamine and thiopental, but not propofol, were evident at clinically relevant concentrations.     

A Subtype of alpha sub 1 Adrenoceptor Mediates Depression of Conduction in Purkinje Fibers Exposed to Halothane

Background: An action of epinephrine at alpha adrenoceptors has been reported to slow conduction in Purkinje fibers exposed to halothane. In Purkinje fibers one pharmacologically distinguishable alpha1 -adrenoceptor subtype (alpha1B) sensitive to the noncompetitive antagonist chloroethylclonidine mediates decreases in automaticity. Another alpha1 subtype (alpha1A), sensitive to the competitive antagonist WB4101, increases spontaneous rate and action potential duration by a mechanism thought to involve hydrolysis of membrane phosphoinositides by phospholipase C. This study examined the dose-response relation and receptor-effector mechanisms underlying depression of conduction in canine Purkinje fibers by epinephrine with halothane.

Methods: Conduction velocity was determined in vitro by measuring the conduction time between action potentials recorded from two Purkinje fibers located about 6 mm apart along the length of free running portions of the ventricular conduction system, the false tendons. Velocity was evaluated at 1-min intervals during trials of rapid exposure to different agonists in groups of 6-12 preparations.

Results: Epinephrine (0.2-5.0 micro Meter) transiently decreased Purkinje conduction velocity in a dose-related manner by as much as 33% (at 5 micro Meter epinephrine with 0.86 mM (2.8%) halothane). Velocity decreased by 5% (P less or equal to 0.01) at an epinephrine concentration similar to "just-threshold" dysrhythmogenic plasma epinephrine concentrations (0.2 micro Meter epinephrine with 0.46 mM halothane) reported in halothane-anesthetized dogs. The decreases of conduction velocity were blocked by prazosin but not by metoprolol, were produced by phenylephrine but not by clonidine, and were antagonized by equimolar (0.5 micro Meter) concentrations of WB4101 more so (P less or equal to 0.01) than by chloroethylclonidine. WB4101 (0.1 micro Meter) produced 87% inhibition of the response to 0.2 micro Meter epinephrine after chloroethylclonidine pretreatment, indicating mediation by the alpha1A subtype. Other agonists linked to cardiac phospholipase C activation, including endothelin 1 (40 nM) and the muscarinic agonist carbamylcholine (1 mM), also decreased conduction velocity in fibers exposed to halothane.     

Hypothermia and Isoflurane Similarly Inhibit Glutamate Release Evoked by Chemical Anoxia in Rat Cortical Brain Slices

Background: Accumulation of the excitatory neurotransmitter glutamate in ischemic brain tissue contributes to neuronal cell death. Volatile anesthetics at clinically relevant concentrations are neuroprotective in in vivo models of brain ischemia and reduce glutamate release in vivo and in vitro, but they appear to have weaker neuroprotective effects than hypothermia. The purpose of this study was to determine whether isoflurane reduces glutamate release in hypoxic brain slices, how large this effect is compared to that of hypothermia, and if it is diminished by hyperthermia.

Methods: Glutamate released from rat cortical brain slices during chemical anoxia (100 micro Meter NaCN) was measured continuously with a fluorescence assay. The release rate was compared at three temperatures (28 degrees Celsius, 37 degrees Celsius, and 39 degrees Celsius) with and without isoflurane at concentrations equipotent to 1 minimum alveolar concentration. At the same three temperatures, glutamate release rates before and after exposure to isoflurane were compared.

Results: Isoflurane reduced glutamate release from brain slices during chemical anoxia at 37 degrees Celsius (19.6%, P < 0.01) and at 39 degrees Celsius (25.4%, P < 0.01), but not at 28 degrees Celsius. The reduction in glutamate release with hypothermia was similar to that with isoflurane. Hyperthermia (39 degrees Celsius) caused greater glutamate release under basal and anoxic conditions than normo- and hypothermia. Isoflurane caused a slight increase in basal glutamate release rates, although this effect was smaller than the increase caused by hyperthermia.     

Effects of Hypothermia, Potassium, and Verapamil on the Action Potential Characteristics of Canine Cardiac Purkinje Fibers

Background: Hypothermia may induce hypokalemia and increase Intracellular Calcium2+ by affecting serum Potassium sup + and Calcium2+ fluxes across the cell membrane. These ionic alterations may significantly change the electrophysiologic characteristics of the cardiac action potential and may induce cardiac arrhythmias. The current study was undertaken to determine whether electrophysiologic changes in Purkinje fibers induced by hypothermia could be reversed by manipulating the extracellular Potassium sup + and transmembrane Calcium2+ fluxes by Calcium2+ channel blockade with verapamil.

Methods: A conventional microelectrode method was used to determine the effects of hypothermia (32 + 0.5 degrees Celsius and 28 + 0.5 degrees Celsius) and various external Potassium sup + concentrations ([Potassium sup +]o) (2.3, 3.8, and 6.8 mM) on maximum diastolic potential, maximum rate of phase 0 depolarization (Vmax), and action potential duration (APD) at 50% (APD50) and at 95% (APD95) repolarization in isolated canine cardiac Purkinje fibers. To evaluate the contribution of the slow inward Calcium2+ current to action potential changes in hypothermia, the experiments were repeated in the presence of the Calcium2+ -channel antagonist verapamil (1 micro Meter).

Results: Variations of [Potassium sup +]o induced the expected shifts in maximum diastolic potential, and hypothermia (28 degrees Celsius) induced moderate depolarization, but only when [Potassium sup +]o was *symbol* 3.9 mM (P < 0.05). Hypothermia decreased Vmax at all [Potassium sup +]o studied (P < 0.05). Regardless of the temperature, Vmax was not affected by verapamil when [Potassium sup +]o *symbol* was 3.9 mM, but at 6.8 mM [Potassium sup +]o in hypothermia Vmax was significantly lower in the presence of verapamil. Hypothermia increased both the APD50 and the APD95. The effects of verapamil on APD were temperature and [Potassium sup +] sub o dependent; between 37 degrees Celsius and 28 degrees Celsius with 2.3 mM [Potassium sup +]o in the superfusate, verapamil did not affect APD. At 28 degrees Celsius in the presence of verapamil, the APD sub 50 and APD95 decreased only if the [Potassium sup +]o was *symbol* 3.9 mM.     

Effects of Halothane and Isoflurane on Carbon Monoxide-induced Relaxations in the Rat Aorta

Background: Halothane and isoflurane previously were reported to attenuate endothelium-derived relaxing factor/nitric oxide-mediated vasodilation and cyclic guanosine monophosphate (cGMP) formation in isolated rat aortic rings. Carbon monoxide has many chemical and physiologic similarities to nitric oxide. This study was designed to investigate the effects of halothane and isoflurane on carbon monoxide-induced relaxations and cGMP formation in the isolated rat aorta.

Methods: isometric tension was recorded continuously from endothelium denuded rat aortic rings suspended in Krebs-filled organ baths. Rings precontracted with submaximal concentrations of norepinephrine were exposed to cumulative concentrations of carbon monoxide (26-176 micro Meter). This procedure was repeated three times, with anesthetics delivered 10 min before the second procedure. Carbon monoxide responses of rings contracted with the same concentration of norepinephrine (10-8 M and 2 x 10-8 M) used in the anesthetic-exposed preparations also were examined. The concentrations of cGMP were determined in denuded rings using radioimmunoassay. The rings were treated with carbon monoxide (176 micro Meter, 30 s) alone, or carbon monoxide after a 10-min incubation with halothane (0.34 mM or 0.72 mM). To determine whether the sequence of anesthetic delivery influenced results, vascular rings pretreated with halothane were compared with non-pretreated rings.

Results: Carbon monoxide (26-176 micro Meter) caused a dose-dependent reduction of norepinephrine-induced tension, with a maximal relaxation of 1.51+/-0.07 g (85+/-7% of norepinephrine-induced contraction). Halothane (0.34 mM and 0.72 mM) significantly attenuated the carbon monoxide-induced relaxations, but only the highest concentration of isoflurane (0.53 mM) significantly attenuated the carbon monoxide-induced relaxations. Carbon monoxide (176 micro Meter) significantly increased cGMP content (+88.1+/-7.1%) and preincubation of the aortic rings with halothane (0.34 mM and 0.72 mM) inhibited this increase (-70.7 +/-6.8% and -108.1+/-10.6%, respectively). When aortic rings and carbon monoxide were added simultaneously to Krebs solution equilibrated with halothane (0.72 mM), no inhibition of cGMP formation occurred.     

Proarrhythmic and Antiarrhythmic Effects of Bupivacaine in an In Vitro Model of Myocardial Ischemia and Reperfusion

Background: Bupivacaine may have toxic cardiovascular effects when accidentally administered by intravascular injection. However, its electrophysiologic effects in the presence of myocardial ischemia remain unknown. The authors evaluated the electrophysiologic and anti- and proarrhythmic effects of bupivacaine in an in vitro model of the ischemic and reperfused myocardium.

Methods: In a double-chamber bath, a guinea pig right ventricular muscle strip was subjected partly to normal conditions and partly to simulated ischemia followed by reperfusion. The electrophysiologic effects of bupivacaine were studied at 1, 5, and 10 micro Meter concentrations.

Results: Bupivacaine (5 and 10 micro Meter) decreased the maximal upstroke velocity of the action potential (Vmax) in normoxic conditions and further decreased (10 micro Meter) the Vmax decrease induced by ischemic conditions. Bupivacaine reduced the mean occurrence time to the onset of myocardial conduction blocks (9 +/- 3 min; mean +/- SD; P < 0.005 with 5 and 10 micro Meter, compared with 17 +/- 6 min during simulated ischemia with no drug or control), and it increased the number of preparations that became inexcitable to pacing (55% of preparations, with 1 micro Meter and 100% with 5 and 10 micro Meter, compared with 17% for the control group). The incidence of spontaneous arrhythmias was reduced by 5 and 10 micro Meter bupivacaine during ischemia and reperfusion and was enhanced by 1 micro Meter bupivacaine during the ischemic phase.