Zvara David A, Bryant Andrew J, Deal Dwight D, DeMarco Mario P, Campos Kevin M, Mansfield Carol M, Tytell Michael
Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27127-1009, USA.
Anesth Analg. 2006 May;102(5):1341-7. doi: 10.1213/01.ane.0000204357.06219.8c.
Anesthetic preconditioning (APC) is a protective mechanism, whereby exposure to a volatile anesthetic renders a tissue resistant to a subsequent ischemic insult. We hypothesized that APC of the rat spinal cord with sevoflurane would reduce neurologic deficit after an ischemic-reperfusion injury. Rats were randomly assigned to 1 of 5 groups. The ischemic preconditioning (IPC) group (n = 14) had 3 min of IPC, 30 min of reperfusion, and 12 min of ischemia. The chronic APC (cSEVO) group (n = 14) had 1 h of APC with 3.5% sevoflurane on each of 2 days before ischemia. The acute APC (aSEVO) group (n = 14) had 1 h of APC with 3.5% sevoflurane followed by a 1-h washout period before the induction of ischemia. The controls (n = 14) underwent no preconditioning before ischemia. IPC attenuated the ischemia-reperfusion injury, whereas aSEVO and cSEVO groups were no better than control animals. Histologic evaluation of the spinal cord showed severe neurologic damage in all groups except for the IPC group and sham-operated rats. APC with sevoflurane did not reduce neurologic injury in a rat model of spinal cord ischemia. Traditional ischemic preconditioning had a strong protective benefit on neurologic outcome.
麻醉预处理（APC）是一种保护机制，即暴露于挥发性麻醉剂可使组织对随后的缺血性损伤产生抗性。我们假设用七氟醚对大鼠脊髓进行APC可减少缺血再灌注损伤后的神经功能缺损。大鼠被随机分为5组中的1组。缺血预处理（IPC）组（n = 14）进行3分钟的IPC、30分钟的再灌注和12分钟的缺血。慢性APC（cSEVO）组（n = 14）在缺血前2天每天用3.5%七氟醚进行1小时的APC。急性APC（aSEVO）组（n = 14）用3.5%七氟醚进行1小时的APC，然后在诱导缺血前有1小时的洗脱期。对照组（n = 14）在缺血前未进行预处理。IPC减轻了缺血再灌注损伤，而aSEVO组和cSEVO组并不比对照动物更好。脊髓的组织学评估显示，除IPC组和假手术大鼠外，所有组均有严重的神经损伤。七氟醚预处理并未减轻大鼠脊髓缺血模型中的神经损伤。传统的缺血预处理对神经结局有很强的保护作用。
