The commonly used stimulant drug methylphenidate, more often referred to as Ritalin, may be of use in the operating room, according to a study in animals conducted at Massachusetts General Hospital. The report, appearing in the October 2011 issue of Anesthesiology, is the first demonstration in mammals of what could be a safe and effective way to induce arousal from general anesthesia.
"If these findings can be replicated in humans," says Emery Brown '87, senior author of the paper, and the Warren M. Zapol Professor of Anaesthesia at Harvard Medical School and Mass General, "it could change the practice of anesthesiology by potentially reducing post-anesthesia complications like delirium and cognitive dysfunction in pediatric and elderly patients."
Methylphenidate is widely used to treat attention-deficit hyperactivity disorder and is known to affect arousal-associated pathways controlled by the neurotransmitters dopamine, norepinephrine, and histamine. The current study showed that the drug stimulated arousal in rats receiving an anesthetic and, if administered before halting anesthesia, prompted a faster recovery than that shown in rats receiving a saline injection. According to the investigators, more precise ways to induce and control the arousal process may lead to strategies that help patients recover from coma. And the ability to safely reduce the time patients spend in the operating room could translate into significant savings in health costs.