颈动脉注射丙泊酚后的脑电静息是通过时间的函数。
Electrocerebral silence after intracarotid propofol injection is a function of transit time.
作者信息
Wang Mei, Joshi Shailendra
机构信息
Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA.
出版信息
Anesth Analg. 2007 Jun;104(6):1498-503, table of contents. doi: 10.1213/01.ane.0000264089.72804.54.
BACKGROUND
We hypothesized that the duration of electrocerebral (electroencephalogram, EEG) silence after bolus injection of propofol, a highly lipid soluble anesthetic drug, during transient cerebral hypoperfusion, will be directly related to the time taken by the bolus of drug to transit the cerebral circulation.
METHODS
We randomly divided 24 New Zealand White rabbits into two propofol volume groups: 0.5 and 0.8 mL groups. In each group, 12 animals received two intracarotid injections of 1% propofol: the first injection was made under normal physiological conditions and the second injection during cerebral hypoperfusion produced by bilateral carotid occlusion and IV bolus injection of adenosine and esmolol. We determined the duration of electrocerebral silence and the transit time of propofol emulsion under both cerebral circulation conditions. The transit time was measured by videomicroscopy through an implanted cranial window.
RESULTS
Cerebral hypoperfusion increased transit time with both low (2.3 +/- 0.7 to 55.7 +/- 21.4 s, n = 12, P < 0.0001) and high (2.2 +/- 0.6 to 62.5 +/- 31 s, n = 12, P < 0.0001) bolus volumes. The duration of electrocerebral silence during cerebral hypoperfusion was a function of the transit time with low (electrocerebral silence s = 152 + 2.3 x transit time, n = 12, r = 0.73, P = 0.007) and high (electrocerebral silence s = 186 + 3.2 x transit time, n = 12, r = 0.68, P = 0.02) bolus volumes.
CONCLUSION
These results suggest that manipulation of the transit time of highly lipid-soluble drugs profoundly enhances the effect site delivery.
背景
我们推测，在短暂性脑灌注不足期间，大剂量注射脂溶性极高的麻醉药物丙泊酚后，脑电（脑电图，EEG）静息持续时间将与药物团注通过脑循环所需时间直接相关。
方法
我们将24只新西兰白兔随机分为两个丙泊酚剂量组：0.5 mL组和0.8 mL组。每组12只动物接受两次颈内动脉注射1%丙泊酚：第一次注射在正常生理条件下进行，第二次注射在双侧颈动脉闭塞及静脉推注腺苷和艾司洛尔导致脑灌注不足时进行。我们测定了两种脑循环条件下的脑电静息持续时间和丙泊酚乳剂的通过时间。通过植入的颅骨视窗用视频显微镜测量通过时间。
结果
无论低剂量（2.3±0.7至55.7±21.4秒，n = 12，P < 0.0001）还是高剂量（2.2±0.6至62.5±31秒，n = 12，P < 0.0001）团注量，脑灌注不足均会增加通过时间。脑灌注不足期间的脑电静息持续时间是通过时间的函数，低剂量（脑电静息时间s = 152 + 2.3×通过时间，n = 12，r = 0.73，P = 0.007）和高剂量（脑电静息时间s = 186 + 3.2×通过时间，n = 12，r = 0.68，P = 0.02）团注量均如此。
结论
这些结果表明，操纵脂溶性高的药物的通过时间可显著增强效应部位给药。
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