Tan Sijie, Xu Changqing, Zhu Wanting, Willis Jesse, Seubert Christoph N, Gravenstein Nikolaus, Sumners Colin, Martynyuk Anatoly E
From the Department of Anesthesiology (S.T., C.X., W.Z., J.W., C.N.S., N.G., A.E.M.), the McKnight Brain Institute (N.G., C.S., A.E.M.), and Department of Physiology and Functional Genomics (C.S.), University of Florida College of Medicine, Gainesville, Florida.
Anesthesiology. 2014 Nov;121(5):1010-7. doi: 10.1097/ALN.0000000000000366.
The authors studied whether neonatal propofol anesthesia affects development of the endocrine and neural systems.
Sprague-Dawley rats were anesthetized using intraperitoneal propofol for 5 h on postnatal days (P) 4, 5, or 6. Pups that received either saline or intralipid, but not those in the negative control groups, were also maternally separated for 5 h. Serum levels of corticosterone were measured immediately after anesthesia and in adulthood after prepulse inhibition of acoustic startle testing (≥P80), followed by measurement of hippocampal neuronal activity.
Propofol acutely increased corticosterone levels to 146.6 ± 23.5 ng/ml (n = 6) versus 16.4 ± 3.5 ng/ml (n = 6) and 18.4 ± 3.2 ng/ml (n = 6) in saline- and intralipd-treated pups, respectively. In adulthood, the propofol group exhibited exacerbated endocrine responses to stress in a form of increased corticosterone levels (1,171.58 ± 149.17 ng/ml [n = 15] vs. 370.02 ± 36.01 ng/ml [n = 10] in the saline group). The propofol group had increased the frequency of miniature inhibitory postsynaptic currents in CA1 neurons of male and female rats, but reduced prepulse inhibition of startle was detected only in males. The Na-K-2Cl cotransporter inhibitor bumetanide, administered to pups before propofol injection, alleviated long-term endocrine and prepulse inhibition abnormalities. Exogenous corticosterone, administered to naive pups, induced synaptic and endocrine but not prepulse inhibition effects, similar to those of propofol.
Propofol-caused acute increases in corticosterone levels and γ-aminobutyric acid type A receptor-mediated excitation at the time of anesthesia may play mechanistic roles in development of exacerbated endocrine responses to stress and neurobehavioral abnormalities.
作者研究了新生儿丙泊酚麻醉是否会影响内分泌和神经系统的发育。
在出生后第4、5或6天,使用腹腔注射丙泊酚对斯普拉格-道利大鼠进行5小时的麻醉。接受生理盐水或脂质乳剂注射的幼崽(而非阴性对照组的幼崽)也会与母鼠分离5小时。在麻醉后立即以及成年后进行听觉惊吓前脉冲抑制测试(≥P80)后测量血清皮质酮水平,随后测量海马神经元活性。
丙泊酚使皮质酮水平急性升高至146.6±23.5 ng/ml(n = 6),而生理盐水处理组和脂质乳剂处理组的幼崽分别为16.4±3.5 ng/ml(n = 6)和18.4±3.2 ng/ml(n = 6)。成年后,丙泊酚组以皮质酮水平升高的形式表现出对应激的内分泌反应加剧(丙泊酚组为1,171.58±149.17 ng/ml [n = 15],生理盐水组为370.02±36.01 ng/ml [n = 10])。丙泊酚组增加了雄性和雌性大鼠CA1神经元微小抑制性突触后电流的频率,但仅在雄性大鼠中检测到惊吓前脉冲抑制降低。在注射丙泊酚前给幼崽注射钠-钾-2氯协同转运体抑制剂布美他尼,可减轻长期的内分泌和前脉冲抑制异常。给未处理的幼崽注射外源性皮质酮,可诱导出与丙泊酚类似的突触和内分泌效应,但无前脉冲抑制效应。
丙泊酚导致麻醉时皮质酮水平急性升高以及γ-氨基丁酸A型受体介导的兴奋,可能在对应激的内分泌反应加剧和神经行为异常的发展中起机制性作用。