Matute E, Rivera-Arconada I, López-García J A
Departamento de Fisiología, Universidad de Alcalá, Madrid 28871, Spain.
Br J Anaesth. 2004 Sep;93(3):422-7. doi: 10.1093/bja/aeh217. Epub 2004 Jul 26.
Spinal actions of halogenated ethers are widely recognized, whereas spinal actions of intravenous anaesthetics like propofol are less clear. The aim of this study was to compare the spinal effects of propofol and sevoflurane.
We used an isolated spinal cord in vitro preparation from rat pups and superfused the anaesthetics at known concentrations. Responses of motoneurones to single and repetitive C-fibre intensity stimulation (trains of 20 stimuli at 1 Hz) of a lumbar dorsal root were recorded from the corresponding ventral root via a suction electrode.
Stimulation trains produced a wind-up of action potentials in motoneurones. Both propofol and sevoflurane produced a significant concentration-dependent depression of the evoked wind-up, although at clinically relevant concentrations sevoflurane exhibited a larger intrinsic efficacy. Applied at anaesthetic concentrations, sevoflurane 250 micro M abolished action potentials whereas propofol 1 micro M only produced a reduction close to 50%. At these concentrations, sevoflurane produced a large depressant effect on the monosynaptic reflex whereas propofol was ineffective.
Sevoflurane produces large inhibitory effects on nociceptive and non-nociceptive reflexes which are likely to contribute to immobility during surgery. Compared with sevoflurane, propofol appears to have much weaker effects on spinal reflexes such as those recorded in an isolated preparation.
卤代醚的脊髓作用已得到广泛认可,而丙泊酚等静脉麻醉药的脊髓作用尚不清楚。本研究旨在比较丙泊酚和七氟醚的脊髓效应。
我们使用新生大鼠的离体脊髓制备物,并用已知浓度的麻醉药进行灌流。通过吸力电极从相应的腹根记录运动神经元对腰背部背根单根和重复C纤维强度刺激(1Hz的20次刺激串)的反应。
刺激串使运动神经元的动作电位出现累加增强。丙泊酚和七氟醚均产生显著的浓度依赖性抑制诱发的累加增强,尽管在临床相关浓度下,七氟醚表现出更大的内在效能。在麻醉浓度下应用时,250μM的七氟醚可消除动作电位,而1μM的丙泊酚仅使动作电位降低近50%。在这些浓度下,七氟醚对单突触反射产生较大的抑制作用,而丙泊酚则无效。
七氟醚对伤害性和非伤害性反射产生较大的抑制作用,这可能有助于手术期间的制动。与七氟醚相比,丙泊酚对脊髓反射(如在离体标本中记录到的反射)的作用似乎要弱得多。