Anesthesia Opioid Pharmacology: Advanced Topics

Experimental Basis for some Opioid Actions

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4Concerning plasticity and opioid activity

 

 

10Nociception:  Glutamate/NMDA System  (illustration by Seward Hung)

 

Met- and Leu- enkephalin

Methionine Enkephalin

Leucine Enkephalin

 

Dynorphin

1Opioids as anesthetics?

1,1g Halothane MAC dependency (rat model) on sufentanil

 

1,1f Reduced thiopental requirement for sleep vs. opioid dose in surgical patients (Fig. 10-9, ref. 1)

MAC value as well as MAC percent reduction is a function of Fentanyl concentration1m

Fentanyl Concentration (ng/mL)

Isoflurane MAC (95% CI,%)

Isoflurane MAC % reduction is a function of fentanyl concentration

0

1.2 (0.99, 1.62)

--

1

0.73 (0.63, 0.88)

39%

2

0.55 (0.45-0.65)

54%

3

0.45 (0.35, 0.54

63%

6

0.30 (0.21, 0.38)

75%

10

0.22 (0.13, 0.30)

82%

1Patient Awareness under General Anesthesia

 

  • 1This graph describes the time course of the EEG spectral edge and serum alfentanil concentration relationships [note that the spectral edge frequencies (right legend) go from relatively low values at the top to high values e.g. 25 cycles per second (Hz) at the bottom. 

  • Therefore at the higher alfentanil concentrations the spectral edge data reflects that the higher frequencies are relatively slow e.g.2-5 cycles per second compared to controls when no drug has been given or after about 20 minutes has elapsed.

  • The alfentanil infusion rate was 1500g/min

 

 

  • 1The relationship between fentanyl serum concentrations and spectral edge data is presented.  As above, the spectral edge scale goes from low-frequency to higher frequency (right). 

  • The spectral edge data change follows serum concentration changes in the fentanyl infusion rate was 150 g/min.

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