Neuroanesthesia Laboratory, Atlanta VA Medical Center/Emory University, Atlanta, GA, USA; Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA; Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA.
Neuroanesthesia Laboratory, Atlanta VA Medical Center/Emory University, Atlanta, GA, USA; Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA.
Behav Brain Res. 2019 Jul 23;367:59-67. doi: 10.1016/j.bbr.2019.03.029. Epub 2019 Mar 18.
Clinical studies have demonstrated sex-related differences in recovery from surgical anesthesia. This study aimed to characterize the emergence pattern following two anesthesia regimens in both sexes of rats. We considered six different markers of emergence from anesthesia: sigh, eye blinking, forelimb movement, mastication, neck extension, and recovery of the righting reflex (RORR). Spontaneous motor activity 24 h after the anesthesia induction was also examined. Our results showed that the rank order of the emergence latency after intraperitoneal propofol, PRO, exposure was forelimb movement < sigh < blink < mastication < neck extension < RORR, while after inhaled isoflurane, ISO, anesthesia the sequence was changed as sigh < blink < mastication < forelimb movement < neck extension < RORR in both male and female rats. Moreover, the latency to emergence after PRO in female rats was significantly higher than male rats, although following ISO there was no difference between the sexes (P < 0.001; P > 0.05, respectively). Open-field testing revealed no difference in PRO and ISO spontaneous locomotor activity due to drug administration (P > 0.05). These two anesthetics presented different emergence sequences. Although clinical data suggests that females arouse faster than males from anesthesia with propofol, our intraperitoneal technique in a rodent model had the opposite effect. Pharmacokinetic analysis demonstrated increased absorption of injected propofol for the female rats in our study, emphasizing the role of sexual dimorphism in drug distribution in rodents. Despite these pharmacokinetic differences, the pharmacodynamic effects of the drugs were remarkably consistent among both sexes through emergence.
临床研究表明，手术麻醉后的恢复存在性别差异。本研究旨在描述两种麻醉方案在雌雄大鼠中的苏醒模式。我们考虑了麻醉苏醒的六个不同标志物：叹气、眨眼、前肢运动、咀嚼、颈部伸展和翻正反射（RORR）的恢复。麻醉诱导后 24 小时还检查了自发性运动活动。结果显示，腹腔注射异丙酚（PRO）后苏醒潜伏期的等级顺序为前肢运动<叹气<眨眼<咀嚼<颈部伸展<RORR，而吸入异氟烷（ISO）麻醉后，该顺序在雌雄大鼠中均变为叹气<眨眼<咀嚼<前肢运动<颈部伸展<RORR。此外，PRO 后雌性大鼠的苏醒潜伏期明显高于雄性大鼠，尽管 ISO 后雌雄大鼠之间无差异（P<0.001；P>0.05，分别）。由于药物给药，旷场测试显示 PRO 和 ISO 自发运动活动没有差异（P>0.05）。这两种麻醉剂呈现出不同的苏醒顺序。尽管临床数据表明，女性从异丙酚麻醉中苏醒的速度比男性快，但我们在啮齿动物模型中的腹腔内技术却产生了相反的效果。药代动力学分析表明，在我们的研究中，雌性大鼠对注射用异丙酚的吸收增加，强调了性别二态性在啮齿动物中药物分布中的作用。尽管存在这些药代动力学差异，但药物的药效学作用在两性之间通过苏醒表现出惊人的一致性。
