Is a new paradigm needed to explain how inhaled anesthetics produce immobility?

Anesth Analg. 2008 Sep;107(3):832-48. doi: 10.1213/ane.0b013e318182aedb.

Abstract

A paradox arises from present information concerning the mechanism(s) by which inhaled anesthetics produce immobility in the face of noxious stimulation. Several findings, such as additivity, suggest a common site at which inhaled anesthetics act to produce immobility. However, two decades of focused investigation have not identified a ligand- or voltage-gated channel that alone is sufficient to mediate immobility. Indeed, most putative targets provide minimal or no mediation. For example, opioid, 5-HT3, gamma-aminobutyric acid type A and glutamate receptors, and potassium and calcium channels appear to be irrelevant or play only minor roles. Furthermore, no combination of actions on ligand- or voltage-gated channels seems sufficient. A few plausible targets (e.g., sodium channels) merit further study, but there remains the possibility that immobilization results from a nonspecific mechanism.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Analgesia*
  • Anesthetics, Inhalation / therapeutic use*
  • Animals
  • Humans
  • Immobilization*
  • Ligands
  • Mice
  • Models, Biological
  • Models, Genetic
  • Models, Theoretical
  • Receptors, GABA-A / metabolism
  • Receptors, Glutamate / therapeutic use
  • Receptors, Serotonin, 5-HT3 / metabolism
  • Sodium Channels / metabolism
  • Static Electricity

Substances

  • Anesthetics, Inhalation
  • Ligands
  • Receptors, GABA-A
  • Receptors, Glutamate
  • Receptors, Serotonin, 5-HT3
  • Sodium Channels