Anesthesia and analgesia
-
Anesthesia and analgesia · Jul 1998
Desflurane and the nonimmobilizer 1,2-dichlorohexafluorocyclobutane suppress learning by a mechanism independent of the level of unconditioned stimulation.
We previously demonstrated that anesthetics and non-immobilizers suppress learning and memory in rats. In the training portion of the test, rats received a light plus a footshock and learned to associate the two, as evidenced by subsequent potentiation of the response (jumping) to light plus a noise (fear-potentiated startle). However, anesthetics and nonimmobilizers also decreased the response of animals receiving footshocks during training, which suggests that the reduction in fear-potentiated startle might reflect analgesia, rather than an impairment of learning and memory. Furthermore, although we previously demonstrated that the nonimmobilizer 2,3-dichlorohexafluorocyclobutane (2N) could completely abolish learning, we did not demonstrate the minimal dose required. In the present study, we eliminated analgesia as a confounding factor by training rats breathing desflurane and 2N with footshock intensities that produced responses at least equal to those produced in control animals. Both desflurane and 2N suppressed learning at 0.2 times the minimum alveolar anesthetic concentration (MAC) or the MAC predicted from lipid solubility, despite the increased footshock intensity. This partial pressure of desflurane equals that previously shown to suppress learning at lower footshock intensities. We conclude that suppression of learning and memory by desflurane and 2N does not result from decreased sensitivity to the unconditioned stimulus (the footshock) and that the potency of 2N is consistent with its lipophilicity. ⋯ General anesthesia eliminates recall of intraoperative events, including pain. Using an animal model, we refuted the hypothesis that lack of recall results from the analgesia (i.e., the reduced response to painful stimuli produced by inhaled drugs) rather than from a direct effect on learning.
-
Anesthesia and analgesia · Jun 1998
Esophageal stethoscope placement depth: its effect on heart and lung sound monitoring during general anesthesia.
Although the esophageal stethoscope has been used for many years, the effect of the depth of placement on the quality of the sounds obtained has never been investigated. The amplitude and frequency characteristics of the first and second heart sound and of inspiratory and expiratory breath sounds were determined at various stethoscope depths (from the distal tip) in 17 healthy anesthetized adults. The amplitude for each type of sound varied markedly with depth. Maximal amplitude for S1 was at 34 +/- 3 cm, for S2 at 27 +/- 2 cm, for inspiratory breath sound at 28 +/- 2 cm, and for expiratory breath sound at 26 +/- 2 cm. There was a positive linear correlation between the depth of maximal amplitude of these sounds and patient height. Peak frequency, in general, did not change with depth. We conclude that investigators should measure and document depth when performing studies involving the esophageal stethoscope. ⋯ Analysis of sound from the esophageal stethoscope at various depths reveals that placement depth greatly affects the sounds. A depth of 28-32 cm is recommended for clinical use; S1, S2, and inspiratory and expiratory sounds have a high amplitude in that range.