Quantitative and Qualitative Effects of Isoflurane on Movement Occurring after Noxious Stimulation

Abstract

Background Anesthetic potency is assessed by determination of the anesthetic concentration that prevents gross, purposeful movement in response to noxious stimulation. It is unclear whether anesthetics cause a progressive decrease in the number and force of limb movements evoked by noxious stimulation, or a step decrease (consistent with an all-or-none effect at the site of action). The authors hypothesized that isoflurane and halothane would progressively depress the movement response. Methods Isoflurane minimum alveolar concentration (MAC) was determined in rats (N = 14) using a clamp applied to a hind paw. Lateral head movements and flexions of the forelimbs and hindlimbs were measured with force transducers. Isoflurane was adjusted to 0.6, 0.9, 1.1, and 1.4 MAC, the noxious stimulus applied, and the force and number of limb and head movements determined. Force and movement determinations were made in seven additional halothane-anesthetized rats. Results Isoflurane MAC was 1.3 +/- 0.1%. In general, if movement occurred after application of the noxious clamp, the head and all limbs were involved. At 0.6 MAC, the median number of extremity and head movements was 3.5 (10th-90th percentile, 2.0-11.4) with force generated per movement (force/movement) = 6.4 (2.0-13.2) N-s. Movement number decreased to 2.1 (0.25-4.2) at 0.9 MAC (P < 0.05), but force/movement was unchanged at 4.5 (0.4-15.1) N-s (Newton-second). At 1.1 MAC, movement number and force/movement decreased to 0.2 (0.0-1.5) and 0.1 (0.0-3.2) N-s, respectively (P < 0.005). No significant movement occurred at 1.4 MAC. The halothane-anesthetized rats had similar findings, although at 0.6 MAC they generated more movements (10.5 [5.2-19.8]) than the rats receiving isoflurane (P < 0.05). Conclusions The results indicate that increasing anesthetic concentration from 0.6 to 0.9 MAC had little effect on the motor system controlling the force of limb movements, and the neural system generating repeated limb movements was depressed, consistent with a differential anesthetic effect at separate sites.