In the initial project (85-88), we demonstrated that a combination of intravenous anesthetics may provide different outcomes (addition, synergism, or antagonism) regarding different components of anesthesia (e.g., unconsciousness or immobility to noxious stimulation). This was based on the suggestion that the spectrum of effects that constitutes the state of general anesthesia should not be regarded as several components of anesthesia resulting from one anesthetic action, but as separate pharmacologic actions, even if the anesthesia is produced by one drug. The primary aim of the project's continuation is to demonstrate that acute tolerance to intravenous anesthetics can be differential for various components of anesthesia. We will concentrate on the three most important components of anesthesia: analgesia, hypnosis, and immobility in response to a noxious stimulus. We will continue to analyze the role of tolerance in analgesic component of anesthesia with opioids.
Specific aims for this segment of the project are to determine: (1) which of the potential mechanisms suggested for the development of chronic tolerance to opioids (NMDA-NO system, cholecystokinin system, hyperalgesic kappa opioid system, protein kinase C system) are involved in the development of acute tolerance to the analgesic effect of alfentanil; (2) if a tonic nociceptive input suppresses the development of acute tolerance to the analgesic effect of alfentanil; (3) and if acute tolerance to the antinociceptive effect of alfentanil decreases analgesic response to alpha-2 adrenergic receptor agonists. We will also test the hypothesis that acute tolerance to thiopental develops to a different degree for hypnosis and immobility to noxious stimulation. Finally, we will test the hypothesis that the combined administration of thiopental and alfentanil results in inhibition of acute tolerance to the hypnotic effects, and that this inhibition is one of the important mechanisms of the thiopental-alfentanil hypnotic synergism. To test the above-indicated hypotheses, we will perform experiments in rats using behavioral methods of assessment of various components of anesthesia and will correlate behavioral endpoints with the plasma and brain concentrations of alfentanil and/or thiopental used for anesthesia induction and maintenance.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Research Project (R01)
Project #
5R01GM035135-17
Application #
6385579
Study Section
Surgery, Anesthesiology and Trauma Study Section (SAT)
Program Officer
Cole, Alison E
Project Start
1985-09-01
Project End
2003-09-29
Budget Start
2001-09-30
Budget End
2003-09-29
Support Year
17
Fiscal Year
2001
Total Cost
$223,360
Indirect Cost
Name
Brigham and Women's Hospital
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02115
Kissin, I; Brown, P T; Bradley Jr, E L (1992) Locomotor activity after recovery from hypnosis: midazolam-morphine versus midazolam. Anesth Analg 75:929-31
Kissin, I; Brown, P T; Bradley Jr, E L (1990) Morphine and fentanyl anesthetic interactions with diazepam: relative antagonism in rats. Anesth Analg 71:236-41
Kissin, I; Brown, P T; Bradley Jr, E L (1990) Sedative and hypnotic midazolam-morphine interactions in rats. Anesth Analg 71:137-43
Kissin, I; Vinik, H R; Castillo, R et al. (1990) Alfentanil potentiates midazolam-induced unconsciousness in subanalgesic doses. Anesth Analg 71:65-9
Kissin, I; Brown, P T; Bradley Jr, E L et al. (1989) Diazepam--morphine hypnotic synergism in rats. Anesthesiology 70:689-94
Kissin, I; Mason 3rd, J O; Bradley Jr, E L (1987) Morphine and fentanyl hypnotic interactions with thiopental. Anesthesiology 67:331-5
Kissin, I; Mason 3rd, J O; Bradley Jr, E L (1986) Morphine and fentanyl interactions with thiopental in relation to movement response to noxious stimulation. Anesth Analg 65:1149-54