Modeling the Effect of Excitation on Depth of Anesthesia Monitoring in γ-Aminobutyric Acid Type A Receptor Agonist ABP-700

ConclusionsThe GABAA receptor agonist ABP-700 shows the expected suppressive effects for BIS and MOAA/S, but also disinhibitory effects for BIS associated with involuntary muscle movements and reduced by pretreatment. Our model provides information about involuntary muscle movements that may be useful to improve depth of anesthesia monitoring for GABAA receptor agonists.Editor ’s PerspectiveWhat We Already Know about This TopicThe γ-aminobutyric acid type A receptor agonist cyclopropyl-methoxycarbonyl metomidate (ABP-700), a second-generation analog of etomidate, produces a rapid onset of sedation and deep general anesthesiaSide effects of ABP-700 include excitatory phenomena such as involuntary muscle movementsWhat This Article Tells Us That Is NewThe effects of involuntary muscle movement on pharmacokinetic-pharmacodynamic models of the effects of ABP-700 on the Bispectral Index (BIS) and the Modified Observer ’s Assessment of Alertness/Sedation scores were studied using data from 266 individualsIn the ABP-700 pharmacokinetic-pharmacodynamic model, a secondary disinhibitory effect-site for BIS that functions in opposition to drug effects underlying suppression of the BIS signal was associated with involuntary muscle movementsThe ABP-700 pharmacokinetic-pharmacodynamic model of its effects on Modified Observer ’s Assessment of Alertness/Sedation scores did not indicate a relationship between involuntary muscle movement and clinical hypnosis

Source: Anesthesiology - December 9, 2020 Category: Anesthesiology Source Type: research