Fleischer J E, Nakakimura K, Drummond J C, Scheller M S, Zornow M H, Grafe M R, Shapiro H M
Department of Anesthesiology, University of California, San Diego, La Jolla 92093-0629.
Crit Care Med. 1992 Jan;20(1):126-34. doi: 10.1097/00003246-199201000-00025.
A study was performed to examine the effects of the calcium-channel blocker levemopamil on neurologic outcome and neuropathology in a clinically relevant model of complete global cerebral ischemia (ventricular fibrillation in cats). Levemopamil was administered to cats starting 5 mins after resuscitation from 14 mins of cardiac arrest. In a "blinded" manner, 46 animals received levemopamil 1 mg/kg over 15 mins followed by 10 micrograms/kg.min for 16 hrs or vehicle. In a nonblinded manner, eight additional animals were pretreated with levemopamil beginning 45 mins before cardiac arrest. After resuscitation, levemopamil was infused at 10 micrograms/kg.min for 16 hrs. Animals in all three groups remained sedated, paralyzed, and mechanically ventilated for 24 to 30 hrs after resuscitation. Neurologic examinations were performed at 2, 4, and 7 days after resuscitation. Thirty-five cats were entered into data analysis (16 levemopamil posttreated, 14 vehicle-treated, and 5 levemopamil pretreated).
Neurologic deficit scores and over-all neuropathologic scores did not differ among groups at any interval after resuscitation. However, the occipital cortex and CA1 region of the pretreated animals showed less severe damage than was observed in the animals that received levemopamil or vehicle, starting after resuscitation (p less than .01).
Postarrest administration of levemopamil was not associated with improved neurologic or neuropathologic outcome. However, the data suggest that prearrest administration may result in regionally selective improvement in neuropathology.
进行了一项研究，以检验钙通道阻滞剂左旋维拉帕米对完全性全脑缺血（猫心室颤动）这一临床相关模型中神经功能结局和神经病理学的影响。从心脏骤停14分钟复苏后5分钟开始给猫使用左旋维拉帕米。以“盲法”给46只动物在15分钟内静脉注射1mg/kg左旋维拉帕米，随后以10μg/kg·min的速度静脉滴注16小时，或给予赋形剂。另外8只动物在心脏骤停前45分钟开始用左旋维拉帕米预处理，此为非盲法。复苏后，以10μg/kg·min的速度静脉滴注左旋维拉帕米16小时。所有三组动物在复苏后均保持镇静、麻痹状态，并接受24至30小时的机械通气。在复苏后第2、4和7天进行神经功能检查。35只猫进入数据分析（16只左旋维拉帕米治疗后组、14只赋形剂治疗组和5只左旋维拉帕米预处理组）。
复苏后任何时间间隔，各组间神经功能缺损评分和总体神经病理学评分均无差异。然而，预处理组动物的枕叶皮质和CA1区损伤程度比接受左旋维拉帕米或赋形剂的动物轻，从复苏后开始（P<0.01）。
复苏后给予左旋维拉帕米与神经功能或神经病理学结局改善无关。然而，数据表明，心脏骤停前给药可能导致神经病理学的区域选择性改善。
