Laalou Fatem-Zohra, de Vasconcelos Anne Pereira, Oberling Philippe, Jeltsch Hélène, Cassel Jean-Christophe, Pain Laure
Groupe de Recherche Expérimentale sur les Répercussions Cognitivo-affectives de l'anesthésie, Inserm U666, France.
Anesthesiology. 2008 May;108(5):888-96. doi: 10.1097/ALN.0b013e31816d919b.
Recent studies have pointed out the involvement of the basal forebrain gamma-aminobutyric acid-mediated system in mediating the effects of general anesthesia. In this study, the authors asked whether the basal forebrain cholinergic system is also involved in mediating the effects of general anesthetics such as propofol.
Cholinergic lesions were produced by administration of the selective immunotoxin 192 immunoglobulin G-saporin into the lateral ventricles, the medial septum, or the nucleus basalis magnocellularis. The anesthetic potency of propofol was determined using an anesthetic score with a crossover counterbalanced design. Animals were given intraperitoneal propofol (25 or 50 mg/kg) repeatedly every 15 min to set up a subanesthetic (low-dose) or anesthetic (high-dose) state. The anesthetic score was assessed for each cumulative dose. Control of the cholinergic depletion was performed using histochemical acetylcholinesterase staining on brain slices.
A shift from a subanesthetic state to an anesthetic state was observed mainly in the rats with the immunotoxin injected into the lateral ventricles or the medial septum and vertical diagonal band of Broca, compared with controls. In those rats, the density of acetylcholinesterase reaction products was normal in the striatum and the thalamus, but reduced in the cortex and the hippocampus.
The anesthetic potency of propofol was increased in all rats with hippocampal lesions, whatever the injection sites, compared with controls. These results demonstrate that a cholinergic dysfunction in the basal forebrain potentiates the anesthetic effects of propofol.
近期研究指出,基底前脑γ-氨基丁酸介导系统参与介导全身麻醉的作用。在本研究中,作者探讨基底前脑胆碱能系统是否也参与介导丙泊酚等全身麻醉药的作用。
通过向侧脑室、内侧隔或大细胞基底核注射选择性免疫毒素192免疫球蛋白G-皂草素造成胆碱能损伤。采用交叉平衡设计的麻醉评分法测定丙泊酚的麻醉效能。每隔15分钟给动物重复腹腔注射丙泊酚(25或50毫克/千克),以建立亚麻醉(低剂量)或麻醉(高剂量)状态。对每个累积剂量评估麻醉评分。利用脑片上的组织化学乙酰胆碱酯酶染色来控制胆碱能耗竭情况。
与对照组相比,主要在向侧脑室、内侧隔以及布罗卡垂直对角带注射免疫毒素的大鼠中观察到从亚麻醉状态转变为麻醉状态。在这些大鼠中,纹状体和丘脑的乙酰胆碱酯酶反应产物密度正常,但皮质和海马体中的密度降低。
与对照组相比,所有海马体损伤的大鼠,无论注射部位如何,丙泊酚的麻醉效能均增加。这些结果表明,基底前脑的胆碱能功能障碍增强了丙泊酚的麻醉作用。