Cholinergic Chemotransmission and Anesthetic Drug Effects at the Carotid Bodies.

Maarten Honing,Albert Dahan,Marieke Niesters,Chris Martini,Monique Van Velzen,Martijn Boon

doi:10.3390/molecules25245974

Maarten Honing, Albert Dahan + Show 4 more

Open Access

https://doi.org/10.3390/molecules25245974

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Abstract

General anesthesia is obtained by administration of potent hypnotics, analgesics and muscle relaxants. Apart from their intended effects (loss of consciousness, pain relief and muscle relaxation), these agents profoundly affect the control of breathing, in part by an effect within the peripheral chemoreflex loop that originates at the carotid bodies. This review assesses the role of cholinergic chemotransmission in the peripheral chemoreflex loop and the mechanisms through which muscle relaxants and hypnotics interfere with peripheral chemosensitivity. Additionally, consequences for clinical practice are discussed.

Highlights

General anesthesia is a pharmacologically induced state which allows exposure to surgical trauma without memory or harmful sympathetic activation
The effect that muscle relaxants and the intravenous hypnotic propofol have on the acute hypoxic ventilatory response will be discussed below
Throughout the human body, cholinergic neurotransmission plays a major role in multiple autonomous functions at various organ systems; we will primarily focus on the role of the nicotinic acetylcholine receptors

Summary

Introduction

General anesthesia is a pharmacologically induced state which allows exposure to surgical trauma without memory or harmful sympathetic activation. Pharmacologic paralysis of skeletal muscles facilitates endotracheal intubation and optimizes surgical working conditions. Apart from their intended effects, anesthetic agents disrupt the control of breathing through effects at central and peripheral chemoreceptive sites [1,2,3,4,5]. Muscle relaxants and intravenous and inhalational anesthetics depress peripheral chemosensitivity [1,4,5,7,8,9]. The mechanism by which muscle relaxants and the intravenous anesthetic agent propofol influence peripheral chemosensitivity involves disruption of cholinergic chemotransmission at the carotid bodies. Cholinergic chemotransmission at the carotid bodies is reviewed and possible mechanisms of anesthetic interference with cholinergic chemotransmission are discussed

Chemosensing at the Carotid Bodies

The Role of Cholinergic Chemotransmission in Chemotransduction

Anesthetic Drug Effects on Peripheral Chemosensitivity

Findings

Anesthetic Perturbation of Peripheral Chemosensitivity