Department of Anesthesiology, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
Department of General surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
PLoS One. 2014 Jan 6;9(1):e84622. doi: 10.1371/journal.pone.0084622. eCollection 2014.
Volatile anesthetics are widely used in pediatric anesthesia but their potential neurotoxicity raise significant concerns regarding sequelae after anesthesia. However, whether physiological disturbance during anesthetic exposure contributes to such side effects remains unknown. The aim of the current study is to compare the neurotoxic effects of isoflurane and sevoflurane in 14 day old rat pups under spontaneous breathing or ventilated conditions.
Postnatal 14 day rats were assigned to one of five groups: 1) spontaneous breathing (SB) + room air (control, n = 17); 2) SB + isoflurane (n = 35); 3) SB + sevoflurane (n = 37); 4) mechanical ventilation (MV) + isoflurane (n = 29); 5) MV + sevoflurane (n = 32). Anesthetized animal received either 1.7% isoflurane or 2.4% seveoflurane for 4 hours. Arterial blood gases and blood pressure were monitored in the anesthetized groups. Neurodegeneration in the CA3 region of hippocampus was assessed with terminal deoxynucleotidyl transferase-mediated DNA nick-end labeling immediately after exposure. Spatial learning and memory were evaluated with the Morris water maze in other cohorts 14 days after experiments.
Most rats in the SB groups developed physiological disturbance whereas ventilated rats did not but become hyperglycemic. Mortality from anesthesia in the SB groups was significantly higher than that in the MV groups. Cell death in the SB but not MV groups was significantly higher than controls. SB + anesthesia groups performed worse on the Morris water maze behavioral test, but no deficits were found in the MV group compared with the controls.
These findings could suggest that physiological disturbance induced by isoflurane or sevoflurane anesthesia may also contribute to their neurotoxicity.
挥发性麻醉剂广泛应用于小儿麻醉,但它们的潜在神经毒性引起了人们对麻醉后后遗症的极大关注。然而,麻醉过程中生理紊乱是否会导致这种副作用尚不清楚。本研究旨在比较异氟醚和七氟醚在自主呼吸和机械通气条件下对 14 日龄大鼠幼仔的神经毒性作用。
将 14 日龄新生大鼠分为五组:1)自主呼吸(SB)+空气(对照组,n=17);2)SB+异氟醚(n=35);3)SB+七氟醚(n=37);4)机械通气(MV)+异氟醚(n=29);5)MV+七氟醚(n=32)。麻醉动物接受 1.7%异氟醚或 2.4%七氟醚麻醉 4 小时。在麻醉组监测动脉血气和血压。用末端脱氧核苷酸转移酶介导的脱氧核苷酸末端标记法在暴露后立即评估海马 CA3 区的神经退行性变。在实验后 14 天,用 Morris 水迷宫评估另一批大鼠的空间学习和记忆能力。
SB 组大多数大鼠出现生理紊乱,而 MV 组大鼠则没有,但出现高血糖。SB 组麻醉死亡率明显高于 MV 组。SB 组而不是 MV 组的细胞死亡明显高于对照组。SB+麻醉组在 Morris 水迷宫行为测试中表现较差,但 MV 组与对照组相比无缺陷。
这些发现可能表明异氟醚或七氟醚麻醉引起的生理紊乱也可能导致其神经毒性。