Drugs of anesthesia, central nicotinic receptors and Parkinson's disease.

General anaesthesia has been shown to be a potential cause of cognitive and memory impairment in patients with PD. Nevertheless, impairment may be not related to anaesthesia per se, but to the drugs administered at the time. Several anaesthesia drugs are known to interact with nAChRs. With regard to muscle relaxants, both atracurium, and the atracurium and cisatracurium metabolite laudanosine, activate alpha4-beta2 nAChRs at concentrations comparable to those measured in the central nervous system during, and for several hours following, general anaesthesia, whereas pancuronium and vecuronium are both nicotinic antagonists. Pancuronium is the more effective antagonist at the alpha4beta2 nAChRs [10].Administration of neuromuscular blocking drugs producing laudanosine could have a potentially therapeutic effect in patients with PD. Therefore, we suggest that laudanosine is an attractive candidate for further clinical trials, especially for anaesthesia related problems in PD.