Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California 94143-0542, USA.
Anesthesiology. 2013 Aug;119(2):335-44. doi: 10.1097/ALN.0b013e31829417f0.
Anesthetic neurotoxicity in the developing brain of rodents and primates has raised concern. Xenon may be a nonneurotoxic alternative to halogenated anesthetics, but its toxicity has only been studied at low concentrations, where neuroprotective effects predominate in animal models. An equipotent comparison of xenon and halogenated anesthetics with respect to neurotoxicity in developing neurons has not been made.
Organotypic hippocampal cultures from 7-day-old rats were exposed to 0.75, 1, and 2 minimum alveolar concentrations (MAC) partial pressures (60% xenon at 1.2, 2.67, and 3.67 atm; isoflurane at 1.4, 1.9, and 3.8%; and sevoflurane at 3.4 and 6.8%) for 6 h, at atmospheric pressure or in a pressure chamber. Cell death was assessed 24 h later with fluorojade and fluorescent dye exclusion techniques.
Xenon caused death of hippocampal neurons in CA1, CA3, and dentate regions after 1 and 2 MAC exposures, but not at 0.75 MAC. At 1 MAC, xenon increased cell death 40% above baseline (P < 0.01; ANOVA with Dunnett test). Both isoflurane and sevoflurane increased neuron death at 1 but not 2 MAC. At 1 MAC, the increase in cell death compared with controls was 63% with isoflurane and 90% with sevoflurane (both P < 0.001). Pretreatment of cultures with isoflurane (0.75 MAC) reduced neuron death after 1 MAC xenon, isoflurane, and sevoflurane.
Xenon causes neuronal cell death in an in vitro model of the developing rodent brain at 1 MAC, as does isoflurane and sevoflurane at similarly potent concentrations. Preconditioning with a subtoxic dose of isoflurane eliminates this toxicity.
在啮齿动物和灵长类动物的发育中的大脑中,麻醉神经毒性引起了关注。氙气可能是一种替代卤代麻醉剂的非神经毒性物质,但它的毒性仅在低浓度下进行了研究,在动物模型中,其神经保护作用占主导地位。尚未对发育中的神经元的氙气和卤代麻醉剂的等效毒性进行比较。
来自 7 天大的大鼠的器官型海马培养物在大气压或压力室中暴露于 0.75、1 和 2 最小肺泡浓度(MAC)分压(60%氙气在 1.2、2.67 和 3.67 大气压;异氟烷在 1.4、1.9 和 3.8%;七氟醚在 3.4 和 6.8%)下 6 小时。24 小时后用荧光素和荧光染料排除技术评估细胞死亡。
氙气在 1 和 2 MAC 暴露后引起 CA1、CA3 和齿状回区的海马神经元死亡,但在 0.75 MAC 时则不会。在 1 MAC 时,氙气使细胞死亡比基础水平增加了 40%(P < 0.01;ANOVA 与 Dunnett 检验)。异氟烷和七氟醚在 1 MAC 时均增加了神经元死亡,但在 2 MAC 时则没有。在 1 MAC 时,与对照相比,细胞死亡的增加分别为异氟烷 63%和七氟醚 90%(均 P < 0.001)。异氟烷(0.75 MAC)预处理培养物可减少 1 MAC 氙气、异氟烷和七氟醚后的神经元死亡。
氙气在体外培养的发育中啮齿动物大脑模型中引起神经元细胞死亡,异氟烷和七氟醚在类似有效的浓度下也引起神经元细胞死亡。用亚毒性剂量的异氟烷预处理可消除这种毒性。