Werner C, Hoffman W E, Thomas C, Miletich D J, Albrecht R F
Michael Reese Hospital and Medical Center, Department of Anesthesiology, Chicago, Illinois 60616.
Anesthesiology. 1990 Nov;73(5):923-9. doi: 10.1097/00000542-199011000-00021.
The authors investigated the effects of nitrous oxide (N2O), ganglionic blockade, and combined infusion of epinephrine and norepinephrine (0.1 microgram.kg-1.min-1 each) on neurologic outcome and brain histopathology in a model of incomplete cerebral ischemia in the rat. Thirty-eight Sprague-Dawley rats were assigned to one of four groups: group 1 (n = 10) received 70% N2O in O2; group 2 (n = 12) received 70% N2O in O2, plus ganglionic blockade; and group 3 (n = 10) received 70% N2O in O2, plus ganglionic blockade and catecholamine infusion. In groups 1-3, ischemia was produced by right carotid occlusion combined with hemorrhagic hypotension (35 mmHg) for 30 min. Group 4 (n = 6) received 70% N2O in O2 and hemorrhagic hypotension without carotid occlusion for 30 min. At the end of ischemic and nonischemic hypotension, the carotid artery was unclamped and the blood slowly reinfused. Neurologic outcome was evaluated for a 5-day period with a graded deficit score (0 = normal to 39 = stroke-related death). Brain histopathology was evaluated in coronal section at the level of the caudate nucleus according to a 6-point scale, from 0 = normal to 5 = total hemispheric infarction. Arterial blood gases, pH, and body temperature were kept constant in all groups. Compared to N2O alone (group 1), treatment with ganglionic blockade (group 2) decreased plasma catecholamines by 75% and significantly improved neurologic outcome from incomplete cerebral ischemia (P less than 0.05). Administration of exogenous epinephrine and norepinephrine in the presence of N2O and ganglionic blockade (group 3) worsened neurologic outcome compared to group 2 (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
作者在大鼠不完全性脑缺血模型中，研究了氧化亚氮（N₂O）、神经节阻滞以及肾上腺素和去甲肾上腺素联合输注（各0.1微克·千克⁻¹·分钟⁻¹）对神经功能转归和脑组织病理学的影响。38只Sprague-Dawley大鼠被分为四组之一：第1组（n = 10）吸入70% N₂O与氧气的混合气体；第2组（n = 12）吸入70% N₂O与氧气的混合气体，外加神经节阻滞；第3组（n = 10）吸入70% N₂O与氧气的混合气体，外加神经节阻滞和儿茶酚胺输注。在第1 - 3组中，通过右侧颈动脉闭塞联合出血性低血压（35 mmHg）30分钟来制造缺血。第4组（n = 6）吸入70% N₂O与氧气的混合气体，且在无颈动脉闭塞的情况下进行出血性低血压30分钟。在缺血性和非缺血性低血压结束时，松开颈动脉夹并缓慢重新输注血液。用分级缺陷评分（0 = 正常至39 = 与中风相关的死亡）对神经功能转归进行为期5天的评估。根据6分制在尾状核水平的冠状切片上评估脑组织病理学，从0 = 正常至5 = 全脑半球梗死。所有组的动脉血气、pH值和体温均保持恒定。与单独使用N₂O（第1组）相比，神经节阻滞治疗（第2组）使血浆儿茶酚胺减少75%，并显著改善了不完全性脑缺血后的神经功能转归（P < 0.05）。与第2组相比，在N₂O和神经节阻滞存在的情况下给予外源性肾上腺素和去甲肾上腺素（第3组）使神经功能转归恶化（P < 0.05）。（摘要截断于250字）
