Abstract

Introduction: Esketamine (Esk) (S(+)-ketamine) is now used as an alternative to its racemic mixture, i. e., ketamine in anesthesia. Esk demonstrated more powerful potency and rapid recovery in anesthesia and less psychotomimetic side effects comparing with ketamine, but Esk could still induce psychological side effects in patients. This study was to investigate whether dexmedetomidine (Dex) can attenuate the Esk-induced neuronal hyperactivities in Kunming mice.Methods: Dexmedetomidine 0.25, 0.5, and 1 mg/kg accompanied with Esk 50 mg/kg were administrated on Kunming mice to assess the anesthesia quality for 1 h. The indicators, such as time to action, duration of agitation, duration of ataxia, duration of loss pedal withdrawal reaction (PWR), duration of catalepsy, duration of righting reflex (RR) loss, duration of sedation, were recorded for 1 h after intraperitoneal administration. The c-Fos expression in the brain was detected by immunohistochemistry and Western Blot after 1 h of administration. Considering the length of recovery time for more than 1 h in Dex and Dex with Esk groups, other mice were repeatedly used to evaluate recovery time from the administration to emerge from anesthesia.Results: Dexmedetomidine dose-dependently increased recovery time when administrated with Esk or alone. Dex combined with Esk efficiently attenuated the duration of agitation, ataxia, and catalepsy. Dex synergically improved the anesthesia of Esk by increasing the duration of sedation, loss of RR, and loss of PWR. Esk induced the high expression of c-Fos in the cerebral cortex, hippocampus, thalamus, amygdala, hypothalamus, and cerebellum 1 h after administration. Western Blot results indicated that Dex at doses of 0.25, 0.5, and 1 mg/kg could significantly alleviate the Esk-induced c-Fos expression in the mice brain.Conclusion: Dexmedetomidine ranged from 0.25 to 1 mg/kg could improve the anesthesia quality and decreased the neuronal hyperactivities and the overactive behaviors when combined with Esk. However, Dex dose-dependently increased the recovery time from anesthesia. It demonstrated that a small dose of Dex 0.25 mg/kg could be sufficient to attenuate Esk-induced psychotomimetic side effects without extension of recovery time in Kunming mice.

Highlights

  • Esketamine (Esk) (S(+)-ketamine) is used as an alternative to its racemic mixture, i. e., ketamine in anesthesia

  • We found that the effects of Esk lasted about 30 min, the effects of Dex lasted over 60 min, and there was almost no overactive behavior after the combination of Esk and Dex except transient ataxia

  • We found that the Esk-induced neuronal side effects were manifested as overactivities in mice behaviors and highly expressed Cellular protooncogene Fos (c-Fos) in mice brains; Dex at doses of 0.25, 0.5, FIGURE 11 | Group analysis of c-Fos expression over the glyceraldehyde-3-phosphate dehydrogenase (GAPDH) ratio in mice whole brain at 1 h after injection. **P < 0.01, compared with saline and Dex groups. ++P < 0.01, compared with the Esk group

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Summary

Introduction

Esketamine (Esk) (S(+)-ketamine) is used as an alternative to its racemic mixture, i. e., ketamine in anesthesia. Catalepsy, amnesia, perception alteration, and out-of-body sense during ketamine anesthesia (Bokor and Anderson, 2014; Grabski et al, 2020). This special anesthesia state indicates that ketamine or Esk induced excitatory activity in some brain regions (Herrera and Robertson, 1990; Vaisanen et al, 2004; Tian et al, 2018). The S (+)-ketamine, was introduced into clinical practice with more potency, less psychotic effects than ketamine and its right-hand enantiomer, R (–)-ketamine (Bauer et al, 2019)

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