Neuromuscular physiology in anaesthetic practice

2017 ◽  
Author(s):  
Philip M. Hopkins
Keyword(s):  
Skeletal Muscle ◽  
Ion Channels ◽  
Muscle Relaxation ◽  
Electrical Potential ◽  
Local Anaesthetics ◽  
Neuromuscular Blocking ◽  
Excitable Cells ◽  
Effector Organ ◽  
Level Of Knowledge ◽  
And Function

The pharmacological interventions that constitute general anaesthesia are targeted at producing unconsciousness and an immobile patient even in response to noxious stimuli. Surgical anaesthesia also requires skeletal muscle relaxation, the degree of which depends on the site and nature of the surgical procedure. The anaesthetist therefore needs an advanced level of knowledge and understanding of the function of nerves, synapses, and muscle in order to understand, from first principles, how the drugs they use every day mediate their effects. Nerves and muscle cells are termed excitable cells because the electrical potential across their cell membranes (membrane potential) can be rapidly and profoundly altered because of the presence of specialized ion channels. Some drugs, such as local anaesthetics, act on ion channels involved in nerve conduction while many others act on synaptic transmission, the neurochemical communication between neurons or between a neuron and its effector organ. The neuromuscular junction is a synapse of specific interest to anaesthetists because it is the site of action of neuromuscular blocking drugs. This chapter covers the fundamentals of cellular electrophysiology, structure and function of key ion channels, and the physiology of nerves, synapses, and skeletal muscle.

The history of anaesthesia

2017 ◽  
Author(s):  
Alistair G. McKenzie
Keyword(s):  
Massachusetts General Hospital ◽  
Muscle Relaxation ◽  
Local Anaesthetics ◽  
Postoperative Recovery ◽  
Neuromuscular Blocking ◽  
Nerve Blocks ◽  
Inhalation Anaesthesia ◽  
Anaesthetic Practice ◽  
Scientific Principles ◽  
Balanced Anaesthesia

Even though ether was prepared in 1540 and nitrous oxide in 1774, it was not until the 1840s that these agents were used to induce anaesthesia to enable painless surgery. Modern inhalation anaesthesia has evolved from the public demonstration of ether anaesthesia by William Morton at the Massachusetts General Hospital, Boston, United States, on 16 October 1846. In the United Kingdom, from 1847 John Snow applied scientific principles to develop safer anaesthetic practice. Newer and safer agents have replaced ether in most countries. Successful intravenous anaesthesia began with chloral hydrate in 1874; progress was hesitant until the wide acceptance of thiopental from 1934—in turn superseded by propofol from 1985. Regional anaesthesia has evolved from the first use of the local anaesthetic, cocaine, to enable awake eye surgery by Carl Koller in 1884. This progressed to nerve blocks, spinal and epidural anaesthesia with a high degree of sophistication, through provision of better and safer local anaesthetics: lidocaine and bupivacaine. The introduction of neuromuscular blocking agents into anaesthetic practice began with the use of curare by Griffith and Johnson in Montreal in 1942. Muscle relaxation became a component of ‘balanced anaesthesia’—necessitating advances in airway management, including tracheal intubation and safe mechanical ventilation of the lungs. The modern anaesthetic workstation for inhalation anaesthesia has evolved from the early anaesthetic machines over 100 years. Of all the advances in anaesthesia during the past 50 years, developments in monitoring techniques—particularly pulse oximetry and capnography—have probably made the greatest contribution to patient safety. Anaesthetists have embraced enhanced postoperative recovery.

scholarly journals Essential Role of Septin 7 in Skeletal Muscle Structure and Function

2020 ◽  
Vol 118 (3) ◽  
pp. 258a
Author(s):  
Laszlo Csernoch ◽  
Mónika Gönczi ◽  
Zsolt Ráduly ◽  
László Szabó ◽  
Nóra Dobrosi ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Essential Role ◽  
Structure And Function ◽  
Muscle Structure ◽  
And Function

scholarly journals Mapping of the contraction-induced phosphoproteome identifies TRIM28 as a significant regulator of skeletal muscle size and function

Cell Reports ◽  
2021 ◽  
Vol 34 (9) ◽  
pp. 108796
Author(s):  
Nathaniel D. Steinert ◽  
Gregory K. Potts ◽  
Gary M. Wilson ◽  
Amelia M. Klamen ◽  
Kuan-Hung Lin ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Size ◽  
And Function

scholarly journals Roles of Microglial Ion Channel in Neurodegenerative Diseases

2021 ◽  
Vol 10 (6) ◽  
pp. 1239
Author(s):  
Alexandru Cojocaru ◽  
Emilia Burada ◽  
Adrian-Tudor Bălșeanu ◽  
Alexandru-Florian Deftu ◽  
Bogdan Cătălin ◽  
...  
Keyword(s):  
Ion Channels ◽  
Neurodegenerative Diseases ◽  
Excitable Cells ◽  
Proton Channels ◽  
Voltage Gated ◽  
Cellular Processes ◽  
Pathological Conditions ◽  
The Common ◽  
Transient Receptor ◽  
The Impact

As the average age and life expectancy increases, the incidence of both acute and chronic central nervous system (CNS) pathologies will increase. Understanding mechanisms underlying neuroinflammation as the common feature of any neurodegenerative pathology, we can exploit the pharmacology of cell specific ion channels to improve the outcome of many CNS diseases. As the main cellular player of neuroinflammation, microglia play a central role in this process. Although microglia are considered non-excitable cells, they express a variety of ion channels under both physiological and pathological conditions that seem to be involved in a plethora of cellular processes. Here, we discuss the impact of modulating microglia voltage-gated, potential transient receptor, chloride and proton channels on microglial proliferation, migration, and phagocytosis in neurodegenerative diseases.

scholarly journals Alterations in intestinal microbiota diversity, composition, and function in patients with sarcopenia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lin Kang ◽  
Pengtao Li ◽  
Danyang Wang ◽  
Taihao Wang ◽  
Dong Hao ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
16S Rrna ◽  
Intestinal Microbiota ◽  
Muscle Growth ◽  
Growth Function ◽  
16S Rrna Sequencing ◽  
Fecal Samples ◽  
Lipopolysaccharide Biosynthesis ◽  
Rrna Sequencing ◽  
And Function

Abstract16S rRNA sequencing of human fecal samples has been tremendously successful in identifying microbiome changes associated with both aging and disease. A number of studies have described microbial alterations corresponding to physical frailty and nursing home residence among aging individuals. A gut-muscle axis through which the microbiome influences skeletal muscle growth/function has been hypothesized. However, the microbiome has yet to be examined in sarcopenia. Here, we collected fecal samples of 60 healthy controls (CON) and 27 sarcopenic (Case)/possibly sarcopenic (preCase) individuals and analyzed the intestinal microbiota using 16S rRNA sequencing. We observed an overall reduction in microbial diversity in Case and preCase samples. The genera Lachnospira, Fusicantenibacter, Roseburia, Eubacterium, and Lachnoclostridium—known butyrate producers—were significantly less abundant in Case and preCase subjects while Lactobacillus was more abundant. Functional pathways underrepresented in Case subjects included numerous transporters and phenylalanine, tyrosine, and tryptophan biosynthesis suggesting that protein processing and nutrient transport may be impaired. In contrast, lipopolysaccharide biosynthesis was overrepresented in Case and PreCase subjects suggesting that sarcopenia is associated with a pro-inflammatory metagenome. These analyses demonstrate structural and functional alterations in the intestinal microbiota that may contribute to loss of skeletal muscle mass and function in sarcopenia.

PROLONGED INTRAVENOUS INFUSION OF LABELLED IODOCOMPOUNDS IN THE RAT: [125I]IODIDE METABOLISM AND EFFECTS OF MODERATE DIETARY IODINE DEFICIENCY

1979 ◽  
Vol 82 (2) ◽  
pp. 227-234 ◽  
Author(s):  
VIPA BOONNAMSIRI ◽  
J. C. KERMODE ◽  
B. D. THOMPSON
Keyword(s):  
Skeletal Muscle ◽  
Iodine Deficiency ◽  
Intravenous Infusion ◽  
Structure And Function ◽  
Continuous Intravenous Infusion ◽  
Close Approximation ◽  
Faecal Excretion ◽  
And Function ◽  
Layer Chromatography ◽  
Secretion Rates

SUMMARY Radio-iodide was administered by prolonged continuous intravenous infusion to rats maintained under iodine-replete conditions and in moderate iodine deficiency. A close approximation to equilibrium labelling was thereby achieved. Labelled iodocompounds extracted from various tissues were analysed by thin-layer chromatography. Moderate iodine deficiency resulted in a slight increase in the ratio of mono-iodotyrosine to di-iodotyrosine in the thyroid. No change in the ratio of tri-iodothyronine (T3) to thyroxine (T4) was found in thyroid, plasma or skeletal muscle. Faecal excretion of T3 declined appreciably relative to that of T4. Under iodine-replete conditions the ratio of thyroidal secretion rates of T3 and T4 was estimated to be more than three times higher than the ratio of these iodocompounds within the thyroid. Heterogeneity of thyroglobulin structure and function may explain these observations.

scholarly journals Skeletal muscle hypertrophy and structure and function of skeletal muscle fibres in male body builders

2006 ◽  
Vol 570 (3) ◽  
pp. 611-627 ◽  
Author(s):  
Giuseppe D'Antona ◽  
Francesca Lanfranconi ◽  
Maria Antonietta Pellegrino ◽  
Lorenza Brocca ◽  
Raffaella Adami ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Hypertrophy ◽  
Structure And Function ◽  
Muscle Fibres ◽  
Male Body ◽  
Skeletal Muscle Hypertrophy ◽  
And Function ◽  
Skeletal Muscle Fibres

scholarly journals The Recent Understanding of the Neurotrophin's Role in Skeletal Muscle Adaptation

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Kunihiro Sakuma ◽  
Akihiko Yamaguchi
Keyword(s):  
Skeletal Muscle ◽  
Neuromuscular Disorders ◽  
Muscle Fibers ◽  
Brain Disorders ◽  
Muscle Adaptation ◽  
Bdnf Mrna ◽  
Pathological Conditions ◽  
Development And Differentiation ◽  
And Function

This paper summarizes the various effects of neurotrophins in skeletal muscle and how these proteins act as potential regulators of the maintenance, function, and regeneration of skeletal muscle fibers. Increasing evidence suggests that this family of neurotrophic factors influence not only the survival and function of innervating motoneurons but also the development and differentiation of myoblasts and muscle fibers. Muscle contractions (e.g., exercise) produce BDNF mRNA and protein in skeletal muscle, and the BDNF seems to play a role in enhancing glucose metabolism and may act for myokine to improve various brain disorders (e.g., Alzheimer's disease and major depression). In adults with neuromuscular disorders, variations in neurotrophin expression are found, and the role of neurotrophins under such conditions is beginning to be elucidated. This paper provides a basis for a better understanding of the role of these factors under such pathological conditions and for treatment of human neuromuscular disease.

scholarly journals Increase of skeletal muscle relaxation speed by direct injection of parvalbumin cDNA.

1995 ◽  
Vol 92 (14) ◽  
pp. 6504-6508 ◽  
Author(s):  
M. Muntener ◽  
L. Kaser ◽  
J. Weber ◽  
M. W. Berchtold
Keyword(s):  
Skeletal Muscle ◽  
Muscle Relaxation ◽  
Direct Injection
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