Department of Anesthesiology, Japanese Red Cross Takayama Hospital, Takayama-City, Gifu, Japan.
Department of Anesthesiology and Pain Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
Korean J Anesthesiol. 2021 Dec;74(6):531-540. doi: 10.4097/kja.21155. Epub 2021 Jun 3.
Cerebral blood flow (CBF) has direct effects on neuronal function and neurocognitive disorders. Oxidative stress from abdominal aortic surgery is important in the pathophysiology of CBF impairment. We investigated the effect of edaravone on the pial arteriolar diameter changes induced by abdominal aortic surgery and the involvement of the endothelium in the changes.
The closed cranial window technique was used in rabbits to measure changes in pial arteriolar diameter after the unclamping of abdominal aortic cross-clamping with an intravenous free radical scavenger, edaravone (control group [n = 6], edaravone 10 μg/kg/min [n = 6], 100 μg/kg/min [n = 6]). Pial vasodilatory responses to topical application of acetylcholine (ACh) into the cranial window were investigated before abdominal aortic cross-clamping and after unclamping with intravenous administration of edaravone (control group [n = 6], edaravone 100 μg/kg/min [n = 6]).
Aortic unclamping-induced vasoconstriction was significantly attenuated by continuous infusion of edaravone at 100 μg/kg/min. Topical ACh after unclamping did not produce any changes in pial arteriolar responses in comparison to before aortic cross-clamping in the control or edaravone groups. The changes in the response to topical ACh after unclamping in the saline and edaravone groups did not differ significantly.
Free radicals during abdominal aortic surgery might have contracted cerebral blood vessels independently of endothelial function in rabbits. Suppression of free radicals attenuated the sustained pial arteriolar vasoconstriction after aortic unclamping. Thus, the free radical scavenger might have some brain protective effect that maintains CBF independently of endothelial function.
脑血流(CBF)直接影响神经元功能和神经认知障碍。腹主动脉手术引起的氧化应激在 CBF 损伤的病理生理学中很重要。我们研究了依达拉奉对腹主动脉阻断解除后脑膜小动脉直径变化的影响及其对变化的内皮参与。
在兔中使用闭合颅窗技术测量腹主动脉阻断解除后脑膜小动脉直径的变化,使用静脉内自由基清除剂依达拉奉(对照组[ n = 6],依达拉奉 10μg/kg/min[ n = 6],100μg/kg/min[ n = 6])。在腹主动脉阻断前和静脉内给予依达拉奉后(对照组[ n = 6],依达拉奉 100μg/kg/min[ n = 6]),研究了向颅窗局部应用乙酰胆碱(ACh)引起的脑膜血管舒张反应。
持续输注 100μg/kg/min 的依达拉奉可显著减轻主动脉阻断解除引起的血管收缩。与主动脉阻断前相比,在对照组或依达拉奉组中,阻断解除后局部应用 ACh 后脑膜小动脉反应没有任何变化。阻断解除后,盐水和依达拉奉组中 ACh 反应的变化差异无统计学意义。
腹主动脉手术期间的自由基可能独立于兔内皮功能收缩脑血管。自由基清除剂抑制主动脉阻断解除后的持续脑膜小动脉收缩。因此,自由基清除剂可能具有一些脑保护作用,可独立于内皮功能维持 CBF。