Decreased Thalamic Activity Is a Correlate for Disconnectedness during Anesthesia with Propofol, Dexmedetomidine and Sevoflurane But Not S-Ketamine

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Decreased Thalamic Activity Is a Correlate for Disconnectedness during Anesthesia with Propofol, Dexmedetomidine and Sevoflurane But Not S-Ketamine

Kantonen, Oskari (författare): Turku PET Centre, University of Turku and Turku University Hospital, Finland ; Department of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, University of Turku, Finland ; Department of Perioperative Services, Intensive Care and Pain Medicine, Satakunta Central Hospital, Pori, Finland

Laaksonen, Lauri (författare): Turku PET Centre, University of Turku and Turku University Hospital, Finland ; Department of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, University of Turku, Finland

Alkire, Michael (författare): Department of Anesthesiology and Perioperative Medicine, University of California, Irvine, USA

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Scheinin, Annalotta (författare): Turku PET Centre, University of Turku and Turku University Hospital, Finland ; Department of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, University of Turku, Finland

Långsjö, Jaakko (författare): Department of Intensive Care, Tampere University Hospital, Finland

Kallionpää, Roosa E. (författare): Department of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, University of Turku, Finland ; Department of Psychology and Speech-Language Pathology, and Turku Brain and Mind Center, University of Turku, Turun yliopisto, Finland

Kaisti, Kaike (författare): Turku PET Centre, University of Turku and Turku University Hospital, Finland ; Department of Anesthesiology and Intensive Care, Oulu University Hospital, Finland

Radek, Linda (författare): Turku PET Centre, University of Turku and Turku University Hospital, Finland

Johansson, Jarkko (författare): Turku PET Centre, University of Turku and Turku University Hospital, Finland ; Department of Radiation Sciences, Umeå University, Sweden

Laitio, Timo (författare): Department of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, University of Turku, Finland

Maksimow, Anu (författare): Department of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, University of Turku, Finland

Scheinin, Joonas (författare): Department of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, University of Turku, Finland

Nyman, Mikko (författare): Department of Radiology, Turku University Hospital, Finland

Scheinin, Mika (författare): Institute of Biomedicine and Unit of Clinical Pharmacology, University of Turku and Turku University Hospital, Turun yliopisto, Finland

Solin, Olof (författare): Turku PET Centre, University of Turku and Turku University Hospital, Finland

Vahlberg, Tero (författare): Institute of Clinical Medicine, Biostatistics, University of Turku and Turku University Hospital, Turun yliopisto, Finland

Revonsuo, Antti (författare): Högskolan i Skövde,Institutionen för biovetenskap,Forskningsmiljön Systembiologi,Department of Psychology and Speech-Language Pathology, and Turku Brain and Mind Center, University of Turku, Turun yliopisto, Finland,Kognitiv neurovetenskap och filosofi, Consciousness and Cognitive Neuroscience

Valli, Katja, 1973- (författare): Högskolan i Skövde,Institutionen för biovetenskap,Forskningsmiljön Systembiologi,Department of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, University of Turku, Finland ; Department of Psychology and Speech-Language Pathology, and Turku Brain and Mind Center, University of Turku, Turun yliopisto, Finland,Kognitiv neurovetenskap och filosofi, Consciousness and Cognitive Neuroscience

Scheinin, Harry (författare): Turku PET Centre, University of Turku and Turku University Hospital, Finland ; Department of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, University of Turku, Finland ; Institute of Biomedicine and Unit of Clinical Pharmacology, University of Turku and Turku University Hospital, Turun yliopisto Finland

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Society for Neuroscience, 2023
2023
Engelska.
Ingår i: Journal of Neuroscience. - : Society for Neuroscience. - 0270-6474 .- 1529-2401. ; 43:26, s. 4884-4895

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Establishing the neural mechanisms responsible for the altered global states of consciousness during anesthesia and dissociating these from other drug-related effects remains a challenge in consciousness research. We investigated differences in brain activity between connectedness and disconnectedness by administering various anesthetics at concentrations designed to render 50% of the subjects unresponsive. One hundred and sixty healthy male subjects were randomized to receive either propofol (1.7 μg/ml; n = 40), dexmedetomidine (1.5 ng/ml; n = 40), sevoflurane (0.9% end-tidal; n = 40), S-ketamine (0.75 μg/ml; n = 20), or saline placebo (n = 20) for 60 min using target-controlled infusions or vaporizer with end-tidal monitoring. Disconnectedness was defined as unresponsiveness to verbal commands probed at 2.5-min intervals and unawareness of external events in a postanesthesia interview. High-resolution positron emission tomography (PET) was used to quantify regional cerebral metabolic rates of glucose (CMRglu) utilization. Contrasting scans where the subjects were classified as connected and responsive versus disconnected and unresponsive revealed that for all anesthetics, except S-ketamine, the level of thalamic activity differed between these states. A conjunction analysis across the propofol, dexmedetomidine and sevoflurane groups confirmed the thalamus as the primary structure where reduced metabolic activity was related to disconnectedness. Widespread cortical metabolic suppression was observed when these subjects, classified as either connected or disconnected, were compared with the placebo group, suggesting that these findings may represent necessary but alone insufficient mechanisms for the change in the state of consciousness.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmaceutiska vetenskaper (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmaceutical Sciences (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)

Nyckelord

Anesthesia
connected
consciousness
disconnected
neuroimaging
positron emission tomography
Consciousness and Cognitive Neuroscience
Kognitiv neurovetenskap och filosofi

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