Molecular, cellular and genetic effects of general anesthetic

Daniela Ionescu¹, Alina Alexe²

1 Catedra ATI III – Universitatea de Medicină şi Farmacie „Iuliu Haţieganu” Cluj-Napoca
2 Clinica ATI – Spitalul Clinic de Urgenţă „Octavian Fodor” Cluj-Napoca

Abstract

Studies published in the last few years have led to the conclusion that the old theory of Meyer-Overton on the action mechanisms of anesthetics is no longer adequate. To date it is accepted that the mechanisms of general anesthetics are a kaleidoscope of actions at cellular, molecular and genetic level. General anaesthetics act at both neuronal and synaptic levels. By their duration of action, anesthetic effects can be classified into of short duration effects: loss of consciousness, amnesia and immobility and of long duration: neuroprotection, neuroplasticity and genetic effects.
Whilst the cellular targets are responsible for the short term effects (mainly GABA-A receptors, ionic channels voltage-gated), the long term effects are due to molecular (enhancement of enzymatic action), cellular (receptors) and genetic mechanisms.
Genetic effects are linked to the concept of neurotoxicity that has been demonstrated to date only on animal studies (mainly on rats).
The clinical impact of neurotoxicity of general anaesthetics in humans and its potential prevention remains to be proven.

Key words: general anaesthetics, mechanisms, molecular targets, genomics