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静脉输注右美托咪定可预防大鼠脊髓缺血无损伤间隔后鞘内注射吗啡所致的脊髓腹侧神经元退变。

Intravenous infusion of dexmedetomidine can prevent the degeneration of spinal ventral neurons induced by intrathecal morphine after a noninjurious interval of spinal cord ischemia in rats.

作者信息

Kakinohana Manabu, Oshiro Masakatsu, Saikawa Satoko, Nakamura Seiya, Higa Tatsuya, Davison Kenneth J, Marsala Martin, Sugahara Kazuhiro

机构信息

Department of Anesthesiology, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.

出版信息

Anesth Analg. 2007 Oct;105(4):1086-93, table of contents. doi: 10.1213/01.ane.0000278641.90190.8d.

Abstract

BACKGROUND

In recent studies, we demonstrated that neuraxial morphine after noninjurious spinal cord ischemia in the rat could induce spastic paraplegia and degeneration of selective spinal ventral neurons. Our objective was to investigate the impact of dexmedetomidine infusion on the degeneration of spinal ventral neurons induced by intrathecal (IT) morphine after spinal cord ischemia.

METHODS

Male Sprague-Dawley rats were given repetitive doses of IT morphine (40 microg x 2) at 1 and 5 h after a noninjurious interval (6 min) of spinal cord ischemia. The animals were assigned to one of the following four groups after the first IT injection (n = 8/group): Group S, IV infusion of saline (mL/h); Group Dex 0.1, dexmedetomidine (0.1 microg . kg(-1) x h(-1)); Group Dex 1, dexmedetomidine (1 microg x kg(-1) x h(-1)); Group Dex 3, dexmedetomidine (3 microg x kg(-1) x h(-1)). Follow-up evaluation included a sedation scale, the Motor Deficit Index to determine neurological dysfunction and histopathology of the spinal cord at 72 h of reperfusion.

RESULTS

IV dexmedetomidine produced a dose-dependent increase in the sedation index. Repetitive IT morphine injection induced paraplegia and degeneration of the spinal ventral neurons. IV dexmedetomidine at a sedative dose in comparison with saline significantly attenuated neurological dysfunction and histopathological consequences.

CONCLUSION

These data show that repetitive administration of IT morphine can induce paraplegia with degeneration of spinal ventral neurons, which can be attenuated by IV dexmedetomidine at a sedative dose. The use of dexmedetomidine may provide beneficial effects on neurological outcome after IT morphine after spinal cord ischemia in rats.

摘要

背景

在最近的研究中,我们证明大鼠非损伤性脊髓缺血后鞘内注射吗啡可诱发痉挛性截瘫和选择性脊髓腹侧神经元变性。我们的目的是研究右美托咪定输注对脊髓缺血后鞘内(IT)吗啡诱导的脊髓腹侧神经元变性的影响。

方法

雄性Sprague-Dawley大鼠在脊髓缺血非损伤间隔(6分钟)后的1小时和5小时接受重复剂量的IT吗啡(40微克×2)。首次IT注射后,将动物分为以下四组之一(每组n = 8):S组,静脉输注生理盐水(毫升/小时);Dex 0.1组,右美托咪定(0.1微克·千克⁻¹·小时⁻¹);Dex 1组,右美托咪定(1微克×千克⁻¹·小时⁻¹);Dex 3组,右美托咪定(3微克×千克⁻¹·小时⁻¹)。随访评估包括镇静评分、运动缺陷指数以确定神经功能障碍以及再灌注72小时时脊髓的组织病理学。

结果

静脉注射右美托咪定使镇静指数呈剂量依赖性增加。重复IT吗啡注射诱发截瘫和脊髓腹侧神经元变性。与生理盐水相比,镇静剂量的静脉注射右美托咪定显著减轻了神经功能障碍和组织病理学后果。

结论

这些数据表明,重复给予IT吗啡可诱发截瘫并伴有脊髓腹侧神经元变性,而镇静剂量的静脉注射右美托咪定可减轻这种情况。右美托咪定的使用可能对大鼠脊髓缺血后IT吗啡治疗后的神经功能结局产生有益影响。

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