Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate
Name
Brown_Active emergence.pdf
Size
1.63 MB
Format
Adobe PDF
Checksum (MD5)
8d8a5a797c4ea173c64d96878c9c8f0b
Author(s)
Chemali, Jessica J.
Van Dort, Christa J.
Brown, Emery N.
Solt, Ken
Date Issued
May 2012
Journal
Anesthesiology
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Citation
Chemali, Jessica J., Christa J. Van Dort, Emery N. Brown, and Ken Solt. “Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate.” Anesthesiology 116, no. 5 (May 2012): 998–1005.
Version
Author's final manuscript
Abstract
Background: A recent study showed that methylphenidate induces emergence from isoflurane general anesthesia. Isoflurane and propofol are general anesthetics that may have distinct molecular mechanisms of action. The objective of this study was to test the hypothesis that methylphenidate actively induces emergence from propofol general anesthesia.
Methods: Using adult rats, the effect of methylphenidate on time to emergence after a single bolus of propofol was determined. The ability of methylphenidate to restore righting during a continuous target-controlled infusion (TCI) of propofol was also tested. In a separate group of rats, a TCI of propofol was established and spectral analysis was performed on electroencephalogram recordings taken before and after methylphenidate administration.
Results: Methylphenidate decreased median time to emergence after a single dose of propofol from 735 s (95% CI: 598–897 s, n = 6) to 448 s (95% CI: 371–495 s, n = 6). The difference was statistically significant (P = 0.0051). During continuous propofol anesthesia with a median final target plasma concentration of 4.0 μg/ml (95% CI: 3.2–4.6, n = 6), none of the rats exhibited purposeful movements after injection of normal saline. After methylphenidate, however, all six rats promptly exhibited arousal and had restoration of righting with a median time of 82 s (95% CI: 30–166 s). Spectral analysis of electroencephalogram data demonstrated a shift in peak power from δ (less than 4 Hz) to θ (4–8 Hz) and β (12–30 Hz) after administration of methylphenidate, indicating arousal in 4/4 rats.
Conclusions: Methylphenidate decreases time to emergence after a single dose of propofol, and induces emergence during continuous propofol anesthesia in rats. Further study is warranted to test the hypothesis that methylphenidate induces emergence from propofol general anesthesia in humans.
MIT Department
Harvard University--MIT Division of Health Sciences and Technology
Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences
Terms of Use
Creative Commons Attribution-Noncommercial-Share Alike
Persistent DSpace Link
DOI of Published Version
https://doi.org/10.1097/ALN.0b013e3182518bfc
