D-amphetamine depresses visual responses in the rat superior colliculus: a possible mechanism for amphetamine-induced decreases in distractibility.

Amphetamines can enhance sustained attention, and reduce distractibility, in normal subjects and patients with attentional-deficit/hyperactivity disorder (ADHD). Their mechanism of action in this regard is unknown, however one possibility is that the drugs affect the superior colliculus (SC), a structure with a clearly defined role in distractibility. The aim of the present studies was to explore the effect of systemically and locally administered d-amphetamine on visual responses in the superficial layers of the SC to wholefield light flashes in the rat, using local field potential and multi-unit recording. Systemic and intra-collicular d-amphetamine both produced a dose-related depression of visual activity, which sometimes progressed to inactivation of the multi-unit response at the highest dose. As a consequence, it is possible that amphetamines enhance sustained attention, and reduce distractibility, via an action on the colliculus. A corollary of this is that collicular dysfunction may underlie enhanced distractibility in ADHD.

Naloxone infusion after prophylactic epidural morphine: effects on incidence of postoperative side-effects and quality of analgesia.

There have been conflicting reports of the value of naloxone infusions to prevent the side-effects associated with epidural morphine. In our study, 29 patients undergoing thoracotomies for pulmonary surgery received epidural morphine (0.1 mg.kg-1) shortly after induction of anaesthesia. One hour after arrival in the Recovery Room, one of four naloxone bolus and infusion sequences was administered: saline bolus followed by saline infusion; 0.4 microgram.kg-1 naloxone bolus followed by 0.4 microgram.kg-1.hr-1 naloxone infusion; 2.0 micrograms.kg-1 naloxone bolus followed by 2.0 micrograms.kg-1.hr-1 naloxone infusion; and 4.0 micrograms.kg-1 naloxone bolus followed by 4.0 micrograms.kg-1.hr-1 naloxone infusion. Although with the number of patients studied, there were no statistically significant differences among groups, clinically, there was a trend toward decreased analgesia with all three naloxone infusion doses as determined by analgesic requirements, longest analgesic-free period and visual analogue pain scores. In addition, side-effects occurred in all groups. We conclude that prophylactic naloxone, used in this manner, is not an appropriate technique for the prevention of side-effects associated with epidural morphine used for the prevention of pain after thoracotomy.