Surgical Center, University of Yamanashi Hospital, Yamanashi, Japan.
J Neurosurg Anesthesiol. 2010 Jul;22(3):207-13. doi: 10.1097/ANA.0b013e3181cd318b.
Propofol and sevoflurane are commonly used anesthetics for neurosurgery. The aim of the study was to compare the effects of propofol with sevoflurane on cerebral pial arteriolar and venular diameters during global brain ischemia and reperfusion.
Japanese white rabbits were anesthetized with propofol (n=11), sevoflurane (n=9), or the combination of sevoflurane and intralipid (n=10). Global brain ischemia was induced by clamping the brachiocephalic, left common carotid, and left subclavian arteries for 15 minutes. Pial microcirculation was observed microscopically through closed cranial windows and measured using a digital-video analyzer. Measurements were recorded before clamping and afterward for 120 minutes.
Plasma glucose and mean arterial blood pressure increased significantly during ischemia in the propofol-anesthetized rabbits. During ischemia, pial arteriolar and venular diameters decreased significantly in all groups. After unclamping, large and small, pial arteriolar and venular diameters increased temporarily and significant dilation was observed in both sevoflurane groups. From 10 minutes after unclamping until the end of the study, large and small arterioles returned to baseline diameters in the sevoflurane groups, but decreased significantly by 10% to 20% in the propofol rabbits. Ischemia-induced adverse effects such as pulmonary edema and acute brain swelling were observed primarily in propofol-anesthetized rabbits.
Propofol and sevoflurane acted differently on pial vessels during reperfusion after ischemic insult. Pial arterioles and venules did not dilate immediately after reperfusion, and subsequently constricted throughout the reperfusion period in propofol-anesthetized rabbits. In contrast, pial arterioles and venules dilated temporarily and returned to baseline in sevoflurane-anesthetized rabbits.
丙泊酚和七氟醚常用于神经外科手术的麻醉。本研究旨在比较丙泊酚和七氟醚对全脑缺血再灌注时脑软脑膜动、静脉直径的影响。
日本白兔分别用丙泊酚（n=11）、七氟醚（n=9）或七氟醚联合脂肪乳（n=10）麻醉。通过夹闭头臂干、左颈总动脉和左锁骨下动脉 15 分钟诱导全脑缺血。通过闭合颅窗显微镜观察软脑膜微循环，并使用数字视频分析仪进行测量。在夹闭前和夹闭后 120 分钟记录测量值。
丙泊酚麻醉兔在缺血过程中血糖和平均动脉压显著升高。在所有组中，缺血期间软脑膜动、静脉直径均显著减小。夹闭后，大、小软脑膜动、静脉直径暂时增大，且七氟醚组均观察到明显扩张。夹闭后 10 分钟至研究结束，七氟醚组大、小动脉恢复至基础直径，但丙泊酚组显著减小 10%至 20%。丙泊酚麻醉兔主要出现肺水肿和急性脑水肿等缺血后不良反应。
缺血再灌注期间，丙泊酚和七氟醚对软脑膜血管的作用不同。再灌注后，软脑膜动、静脉未立即扩张，随后在丙泊酚麻醉兔的再灌注期间持续收缩。相比之下，软脑膜动、静脉在七氟醚麻醉兔中暂时扩张并恢复至基础水平。
