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瑞芬太尼和丙泊酚对缺血再灌注模型中远处器官肺损伤的影响。

Effects of remifentanil and propofol on distant organ lung injury in an ischemia-reperfusion model.

作者信息

Kanbak Orhan, Aydoğan Burcu, Gümüş Tülin

机构信息

Anesthesiology and Reanimation Department, Ankara City Hospital, Mutlukent mh. 2023 sok. No: 13 Çankaya, Ankara 06800, Turkey.

Anesthesiology and Reanimation Department, İstanbul Metin Sabancı Baltalimanı Bone Diseases Education and Research Hospital, İstanbul, Turkey.

出版信息

Open Med (Wars). 2021 Nov 8;16(1):1673-1680. doi: 10.1515/med-2021-0381. eCollection 2021.

Abstract

Our aim was to evaluate lung injury due to oxidative stress and antioxidant activity levels in an infrarenal ischemia-reperfusion model and to compare prevention effects of single and combined use of propofol and remifentanil. In this study, a total of 40 adult Wistar Albino rats were randomly divided into five groups of eight rats as SHAM, physiological saline, intraperitoneal propofol, remifentanil, and propofol and remifentanil groups. Blood and tissue samples were obtained after 80 min of reperfusion. The malondialdehyde (MDA) level, a measure of lipid peroxidation, was measured in lung tissue samples and red blood cells; additionally, total oxidant status and total antioxidant capacity of lung tissues were measured and histopathological examination was performed. Distant organ (lung) injury developed due to lower extremity ischemia-reperfusion was created by infrarenal aortic clamping. The lipid peroxidation product MDA and total oxidant levels were increased, but there was insufficient antioxidant protection both in the lung tissues and red blood cells. While propofol prevented this injury consistent with its proposed antioxidant properties; no protective effect of remifentanil was observed. On the contrary, it showed oxidative stress increasing effect. This study concluded that the antioxidant effect of propofol was suppressed by remifentanil in the case of combined use.

摘要

我们的目的是评估肾下缺血再灌注模型中氧化应激所致的肺损伤及抗氧化活性水平,并比较丙泊酚和瑞芬太尼单独使用及联合使用的预防效果。在本研究中,总共40只成年Wistar白化大鼠被随机分为五组,每组8只,分别为假手术组、生理盐水组、腹腔注射丙泊酚组、瑞芬太尼组以及丙泊酚和瑞芬太尼联合组。再灌注80分钟后采集血液和组织样本。测定肺组织样本和红细胞中丙二醛(MDA)水平(脂质过氧化的指标);此外,测定肺组织的总氧化状态和总抗氧化能力,并进行组织病理学检查。通过肾下主动脉夹闭造成下肢缺血再灌注引起的远隔器官(肺)损伤。脂质过氧化产物MDA和总氧化水平升高,但肺组织和红细胞中的抗氧化保护均不足。丙泊酚与其所具有的抗氧化特性一致,可预防这种损伤;未观察到瑞芬太尼的保护作用。相反,它显示出氧化应激增强作用。本研究得出结论,联合使用时瑞芬太尼会抑制丙泊酚的抗氧化作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c7/8576613/bd2d6e7a9ed6/j_med-2021-0381-fig001.jpg

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