Yin Yu-Hua, Wang Fei, Pan Yao-Hua, Wang Yong, Wang Yu, Luo Qi-Zhong, Jiang Ji-Yao
Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
Am J Med Sci. 2009 Feb;337(2):123-5. doi: 10.1097/MAJ.0b013e31817d1ca1.
To explore the dose-response effects of topical administration of nimodipine on cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) in rabbits.
The CVS model was established by injection of fresh autologous nonheparinized arterial blood into the subtemporal area of basilar cisterns. The 24 CVS animals were randomly divided into 4 groups, group I (n=7): nimodipine original stock solution/normal saline=1/19 (0.01 mg/mL); group II (n=6): nimodipine original stock solution/normal saline=1/9 (0.02 mg/mL); group III (n=5): nimodipine original stock solution/normal saline=1/4 (0.04 mg/mL); and group IV (n=6) with no nimodipine, but 5% ethanol dissolved in normal saline as the control group. The operative area was administrated with nimodipine at different concentrations or alcohol-saline at 3 days after SAH. The blood flow velocity of middle cerebral artery was measured at 5, 15, 30, and 60 minutes after topical administration of nimodipine by transverse cerebellar diameter monitoring.
Blood flow velocity of middle cerebral artery in group II (0.02 mg/mL) and in group III (0.04 mg/mL) significantly decreased at 60 and 15 minutes, respectively, after topical administration of nimodipine (P<0.05), and even more significantly at 30 and 60 minutes after topical administration of nimodipine in group III (0.04 mg/mL) (P<0.01).
Topical administration of nimodipine at the concentrations of 1:5 (0.04 mg/mL) and 1:10 (0.02 mg/mL) significantly alleviates CVS after SAH, which indicates that topical administration of nimodipine may be useful for CVS of patients with SAH during surgical clip of intracranial aneurysms.
探讨兔蛛网膜下腔出血(SAH)后局部应用尼莫地平对脑血管痉挛(CVS)的剂量反应效应。
通过将新鲜自体未肝素化动脉血注入基底池颞下区建立CVS模型。24只CVS动物随机分为4组,Ⅰ组(n = 7):尼莫地平原液/生理盐水 = 1/19(0.01 mg/mL);Ⅱ组(n = 6):尼莫地平原液/生理盐水 = 1/9(0.02 mg/mL);Ⅲ组(n = 5):尼莫地平原液/生理盐水 = 1/4(0.04 mg/mL);Ⅳ组(n = 6)不使用尼莫地平,用5%乙醇溶于生理盐水作为对照组。SAH后3天在手术区域给予不同浓度的尼莫地平或酒精生理盐水。通过横小脑直径监测在局部应用尼莫地平后5、15、30和60分钟测量大脑中动脉血流速度。
局部应用尼莫地平后,Ⅱ组(0.02 mg/mL)大脑中动脉血流速度在60分钟时显著降低,Ⅲ组(0.04 mg/mL)在15分钟时显著降低(P < 0.05),Ⅲ组(0.04 mg/mL)在局部应用尼莫地平后30和60分钟时降低更显著(P < 0.01)。
局部应用浓度为1:5(0.04 mg/mL)和1:10(0.02 mg/mL)的尼莫地平可显著减轻SAH后的CVS,这表明在颅内动脉瘤手术夹闭期间局部应用尼莫地平可能对SAH患者的CVS有用。