Zapp M, Kofke W A, Davis D W
Department of Anesthesia, College of Medicine, University of Florida, Gainesville.
Neurochem Res. 1992 Apr;17(4):301-5. doi: 10.1007/BF00974569.
The effects of varying concentrations and types of volatile anesthetics on neurochemical sequelae of brain ischemia were evaluated in the rat. Rats were assigned to treatment defined by a 3 x 3 design (anesthetic type and dose) with 5 rats/cell. Each group received halothane, enflurane, or isoflurane 0.5, 1.0, or 2.0 MAC (minimal alveolar concentration). This was followed by preischemic plasma glucose sampling, 5 min hypotension (30 mmHg) and 5 min decapitation cerebral ischemia. Preischemia plasma glucose increased with increasing anesthetic concentration and was highest in the isoflurane groups, varying from a low (+/- SD) of 7.19 +/- 1.79 mumol/ml in the 0.5 MAC halothane group to a high of 12.68 +/- 3.65 mumol/ml in the 2.0 MAC isoflurane group. End-ischemic brain lactate correlated with preischemic plasma glucose (r = 0.5, alpha = 0.5). We conclude that increasing concentration of volatile anesthesia with iv phenylephrine blood pressure support produces higher levels of plasma glucose and brain lactate with cerebral ischemia.
在大鼠中评估了不同浓度和类型的挥发性麻醉剂对脑缺血神经化学后遗症的影响。大鼠被分配到采用3×3设计(麻醉剂类型和剂量)的治疗组,每组5只大鼠。每组接受0.5、1.0或2.0 MAC(最低肺泡浓度)的氟烷、恩氟烷或异氟烷。随后进行缺血前血浆葡萄糖采样、5分钟低血压(30 mmHg)和5分钟断头脑缺血。缺血前血浆葡萄糖随着麻醉剂浓度的增加而升高,在异氟烷组中最高,范围从0.5 MAC氟烷组的低水平(±标准差)7.19±1.79 μmol/ml到2.0 MAC异氟烷组的高水平12.68±3.65 μmol/ml。缺血末期脑乳酸与缺血前血浆葡萄糖相关(r = 0.5,α = 0.5)。我们得出结论,在静脉注射去氧肾上腺素维持血压的情况下,增加挥发性麻醉剂的浓度会导致脑缺血时血浆葡萄糖和脑乳酸水平升高。