Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate
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 ind...
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| Format: | Article |
| Language: | en_US |
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Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
2014
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| Online Access: | http://hdl.handle.net/1721.1/86319 https://orcid.org/0000-0001-5328-2062 https://orcid.org/0000-0003-2668-7819 |
| _version_ | 1811069245528735744 |
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| author | Chemali, Jessica J. Van Dort, Christa J. Brown, Emery N. Solt, Ken |
| author2 | Harvard University--MIT Division of Health Sciences and Technology |
| author_facet | Harvard University--MIT Division of Health Sciences and Technology Chemali, Jessica J. Van Dort, Christa J. Brown, Emery N. Solt, Ken |
| author_sort | Chemali, Jessica J. |
| collection | MIT |
| description | 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. |
| first_indexed | 2024-09-23T08:08:02Z |
| format | Article |
| id | mit-1721.1/86319 |
| institution | Massachusetts Institute of Technology |
| language | en_US |
| last_indexed | 2024-09-23T08:08:02Z |
| publishDate | 2014 |
| publisher | Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins |
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| spelling | mit-1721.1/863192022-09-23T11:06:11Z Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate Chemali, Jessica J. Van Dort, Christa J. Brown, Emery N. Solt, Ken Harvard University--MIT Division of Health Sciences and Technology Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences Brown, Emery N. Solt, Ken 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. National Institutes of Health (U.S.) (Grant DP1-OD003646) National Institutes of Health (U.S.) (Grant K08-GM094394) Massachusetts General Hospital. Dept. of Anesthesia and Critical Care 2014-05-01T14:21:29Z 2014-05-01T14:21:29Z 2012-05 2011-11 Article http://purl.org/eprint/type/JournalArticle 0003-3022 http://hdl.handle.net/1721.1/86319 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. https://orcid.org/0000-0001-5328-2062 https://orcid.org/0000-0003-2668-7819 en_US http://dx.doi.org/10.1097/ALN.0b013e3182518bfc Anesthesiology Creative Commons Attribution-Noncommercial-Share Alike http://creativecommons.org/licenses/by-nc-sa/4.0/ application/pdf Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins |
| spellingShingle | Chemali, Jessica J. Van Dort, Christa J. Brown, Emery N. Solt, Ken Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate |
| title | Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate |
| title_full | Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate |
| title_fullStr | Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate |
| title_full_unstemmed | Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate |
| title_short | Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate |
| title_sort | active emergence from propofol general anesthesia is induced by methylphenidate |
| url | http://hdl.handle.net/1721.1/86319 https://orcid.org/0000-0001-5328-2062 https://orcid.org/0000-0003-2668-7819 |
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