Skip to main content
SpringerLink
Log in

A Concept for Assessing Anesthetic Interactions

  • Chapter
Anesthesia for the New Millennium

Part of the book series: Developments in Critical Care Medicine and Anesthesiology ((DCCA,volume 34))

  • 132 Accesses

Abstract

According to classic theories of anesthesia based on unitary nonspecific mechanisms of anesthetic actions, one anesthetic may be replaced freely by another, and, in the case of anesthetic combinations, the anesthetic effect of mixtures is expected to be additive (10). However, even if the state of general anesthesia is narrowed to only one of its components and the type of interacting drugs is restricted to inhaled anesthetics, some deviations from additivity can be found (5,7). A rapid increase in the use of intravenous drugs for general anesthesia, especially those acting via specific receptors, is the most important factor requiring revision of the above indicated conceptual approach to anesthetic interactions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Alifimoff JK, Miller KW: Mechanisms of action of general anesthetic agents. In: Rogers MC et al., eds. Principles and practice of anesthesiology. St. Louis: Mosby, 1993:1034–52

    Google Scholar 

  2. Antognini JF, Schwartz K: Exaggerated anesthetic requirements in the preferentially anesthetized brain. Anesthesiology 1993;79:1244–9

    Article  PubMed  CAS  Google Scholar 

  3. Belelli D, Lambert JJ, Peters JA, et al: The interaction of the general anesthetic etomidate with the g-aminobutyric acid type A receptor is influenced by a single amino acid. Proc Natl Acad Sci USA 1997;94:11031–6

    Article  PubMed  CAS  Google Scholar 

  4. Cohen PJ: History and theories of general anesthesia. In: Goodman LS and Gilman A, eds. The pharmacological basis of therapeutics. 5th ed. New York: MacMillan Publishing Co., 1975: 53–9

    Google Scholar 

  5. Cole DJ, Kalichman MW, Shapiro HM, Drummond JC: The non linear potency of sub-MAC concentrations of nitrous oxide in decreasing the anesthetic requirement of enflurane, halothane, and isoflurane in rats. Anesthesiology 1990;73:93–9

    Article  PubMed  CAS  Google Scholar 

  6. Deady J, Koblin DD, Eger EI II, et al: Anesthetic potencies and the unitary theory of narcosis. Anesth Analg 1981;60:380–386

    Article  PubMed  CAS  Google Scholar 

  7. DiFazio CA, Brown RE, Ball CG, et al: Additive effects of anesthetics and theories of anesthesia. Anesthesiology 1972;36:57–63

    Article  PubMed  CAS  Google Scholar 

  8. Dluzewski AR, Halsey MJ, Simmonds AC: Membrane interactions with general and local anesthetics: A review of molecular hypothesis of anesthesia. Molec Aspect Med 1983;6:459–83

    Article  CAS  Google Scholar 

  9. Dwyer R, Bennett HL, Eger EI II, Heilbron D: Effect of isoflurane and nitrous oxide in subanesthetic concentrations on memory and responsiveness in volunteers. Anesthesiology 1992;77:888–98

    Article  PubMed  CAS  Google Scholar 

  10. Eger EI II: Does 1+1=2? (Editorial) Anesth Analg 1989;68:551–2

    PubMed  CAS  Google Scholar 

  11. Eger EI II: What is general anesthetic action? Anesth Analg 1993;77:408

    PubMed  CAS  Google Scholar 

  12. Eger EI II, Koblin DD, Harris RA, et al: Hypothesis inhaled anesthetics produce immobility and amnesia by different mechanisms at different sites. Anesth Analg 1997; 84:915–8

    PubMed  CAS  Google Scholar 

  13. Eger EI II, Koblin DD, Laster MJ, et al: Minimum alveolar anesthetic concentration values for the enantiomers of isoflurane differ minimally. Anesth Analg 1997;85:188–92

    PubMed  CAS  Google Scholar 

  14. Franks NP, Lieb WR: Do general anaesthetics act by competitive binding to specific receptors? Nature 1984;310:599–601

    Article  PubMed  CAS  Google Scholar 

  15. Franks NP, Lieb WR: Molecular and cellular mechanisms of general anesthetics. Nature 1994;367:607–14

    Article  PubMed  CAS  Google Scholar 

  16. Gaumann DM, Mustaki JP, Tassonyi E: MAC-awake of isoflurane, enflurane, and halothane evaluated by slow and fast alveolar washout. Br J Anaesth 1992;68:81–4

    Article  PubMed  CAS  Google Scholar 

  17. Halsey MJ: Mechanisms of general anesthesia. In: Eger EI II, ed. Anesthetic uptake and action. Baltimore: Williams and Wilkins Co., 1974:45–76

    Google Scholar 

  18. Halsey MJ, Green CJ, Wardley-Smith B: Renaissance of non unitary molecular mechanisms of general anesthesia. In: Find R, ed. Molecular mechanisms of anesthesia (Progress in anesthesiology, vol. 2). New York: Raven Press, 1980: 273–83

    Google Scholar 

  19. Hug Jr CC: Does opioid anesthesia exist? (Editorial) Anesthesiology 1990;73:1–4

    Article  PubMed  Google Scholar 

  20. Kissin I: General anesthetic action: an obsolete notion? Anesth Analg 1993;76:215–18

    Article  PubMed  CAS  Google Scholar 

  21. Kissin I, Gelman S: Components of anaesthesia. Br J Anaesth 1988;61:237–42

    Article  PubMed  CAS  Google Scholar 

  22. Kissin I, McGee T, Smith LR: The indices of potency for intravenous anaesthetics. Can Anaesth Soc J 1981;28:585–90

    Article  PubMed  CAS  Google Scholar 

  23. Kissin I, Morgan PL, Smith LR: Anesthetic potencies of isoflurane, halothane and diethyl ether for various endpoints of anesthesia. Anesthesiology 1983;58:88–92

    Article  PubMed  CAS  Google Scholar 

  24. Krnjevic K: Cellular mechanisms of anesthesia. Ann NY Acad Sci 1991;625:1–16

    Article  PubMed  CAS  Google Scholar 

  25. Lysko GS, Robinson JL, Casto R, Ferrone RA: The stereospecific effects of isoflurane isomers in vivo. Eur J Pharmacol 1994; 263:25–9

    Article  PubMed  CAS  Google Scholar 

  26. Mihic SJ, Ye Q, Wick M, et al: Sites of alcohol and volatile anaesthetic action on GABAA and glycine receptors. Nature 1997; 389:385–9

    Article  PubMed  CAS  Google Scholar 

  27. Pinsker MC: Anesthesia: a pragmatic construct. Anesth Analg 1986;65:819–20

    Article  PubMed  CAS  Google Scholar 

  28. Prys-Roberts C: Anaesthesia: A practical or impractical construct? Br J Anaesth 1987;59:1341–5

    Article  PubMed  CAS  Google Scholar 

  29. Quinlan JJ, Homanics GE, Firestone, LL: Anesthesia sensitivity in mice that lack the b3 subunit of the g-aminobutyric acid type A receptor. Anesth Analg 1998; 88:775–80

    CAS  Google Scholar 

  30. Rampil IJ: Anesthetic potency is not altered after hypothermic spinal cord transection in rats. Anesthesiology 1994;80:606–10

    Article  PubMed  CAS  Google Scholar 

  31. Rampil IJ, Mason P, Singh H: Anesthetic potency (MAC) is independent of forebrain structures in the rat. Anesthesiology 1993;78:707–12

    Article  PubMed  CAS  Google Scholar 

  32. Richards CD: In search of anesthesia. Trends Neurol Sci 1980;3:9–13

    CAS  Google Scholar 

  33. Richards CD: The synaptic basis of general anaesthesia. Eur J Anaesthesiol 1995;12:5–19

    PubMed  CAS  Google Scholar 

  34. Shim CY, Anderson NB: Minimum alveolar concentration and dose-response curves in anesthesia. Anesthesiology 1972;36:146–51

    Article  PubMed  CAS  Google Scholar 

  35. Stanski DR. Monitoring depth of anesthesia. In: Miller RD, ed. Anesthesia, 4th ed. New York: Churchill Livingstone, 1994: 1127–59

    Google Scholar 

  36. Tomlin SL, Jenkins A, Lieb WR, Franks NP: Steroselective effects etomidate optical isomers on gamma-aminobutyric acid type A receptors and animals. Anesthesiology 1998; 88:708–17

    Article  PubMed  CAS  Google Scholar 

  37. Wall PD: Mechanisms of general anesthesia. Anesthesiology 1967;28:46–51

    Article  PubMed  CAS  Google Scholar 

  38. Woodbridge PD: Changing concepts concerning depth of anesthesia. Anesthesiology 1957;18:536–50

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Igor Kissin
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, The University of Utah Medical School, Salt Lake City, Utah, USA

    Theodore H. Stanley  & Talmage D. Egan  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Kissin, I. (1999). A Concept for Assessing Anesthetic Interactions. In: Stanley, T.H., Egan, T.D. (eds) Anesthesia for the New Millennium. Developments in Critical Care Medicine and Anesthesiology, vol 34. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4566-4_16

Download citation

  • DOI: https://doi.org/10.1007/978-94-011-4566-4_16

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-5935-0

  • Online ISBN: 978-94-011-4566-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation