Does the brain influence somatic responses to noxious stimuli during isoflurane anesthesia? 1994

M Borges, and J F Antognini
Department of Anesthesiology, University of California-Davis 95616-8634.

BACKGROUND Recent evidence suggests that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Whether the brain influences this response is not clear. This study was designed to test the hypothesis that the brain affects anesthetic requirements. METHODS Six goats were anesthetized with isoflurane. After tracheal intubation and femoral arterial cannulation, bilateral neck dissections were performed to isolate the external carotid arteries and external jugular veins. The occipital arteries were ligated bilaterally. Control isoflurane requirements as defined by the minimum alveolar concentration (MAC) were determined by using a dew-claw clamp as a painful stimulus. Cranial venous blood was drained into a bubble oxygenator in which an isoflurane vaporizer was placed in line with the gas flow, and arterial blood was infused into a carotid artery with a roller pump. This arrangement permitted selective control of the delivery of anesthetic to the head and to the systemic circulation. Isoflurane concentration in the arterial blood delivered to the head was estimated from the isoflurane concentration in the oxygenator exhaust. While isoflurane concentration in the head was maintained at approximately 0.2-0.3%, MAC for the body was determined. After return to the native circulation, MAC was determined again. RESULTS During bypass with cranial isoflurane concentration at 0.2-0.3%, all animals showed varying, intermittent degrees of light anesthesia, including spontaneous head movement, chewing, swallowing, and eye opening. Isoflurane MAC was 1.4 +/- 0.2% (mean +/- SD) at baseline, decreased to 0.8 +/- 0.1% during bypass (P < 0.05), and increased to 1.2 +/- 0.2% after bypass (P not significant compared with baseline). CONCLUSIONS These results verify the importance of volatile anesthetic action at an extracranial site vis à vis purposeful movement in response to a noxious stimulus. Furthermore, the results confirm that the brain affects anesthetic requirements.

UI MeSH Term Description Entries
D007530 Isoflurane A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
D010146 Pain An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS. Suffering, Physical,Ache,Pain, Burning,Pain, Crushing,Pain, Migratory,Pain, Radiating,Pain, Splitting,Aches,Burning Pain,Burning Pains,Crushing Pain,Crushing Pains,Migratory Pain,Migratory Pains,Pains, Burning,Pains, Crushing,Pains, Migratory,Pains, Radiating,Pains, Splitting,Physical Suffering,Physical Sufferings,Radiating Pain,Radiating Pains,Splitting Pain,Splitting Pains,Sufferings, Physical
D010812 Physical Stimulation Act of eliciting a response from a person or organism through physical contact. Stimulation, Physical,Physical Stimulations,Stimulations, Physical
D001784 Blood Gas Analysis Measurement of oxygen and carbon dioxide in the blood. Analysis, Blood Gas,Analyses, Blood Gas,Blood Gas Analyses,Gas Analyses, Blood,Gas Analysis, Blood
D001786 Blood Glucose Glucose in blood. Blood Sugar,Glucose, Blood,Sugar, Blood
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D006041 Goats Any of numerous agile, hollow-horned RUMINANTS of the genus Capra, in the family Bovidae, closely related to the SHEEP. Capra,Capras,Goat
D000758 Anesthesia A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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