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硫喷妥钠的预防性大剂量注射不能预防长时间的局灶性脑缺血。

A prophylactic bolus of thiopentone does not protect against prolonged focal cerebral ischaemia.

作者信息

Gelb A W, Floyd P, Lok P, Peerless S J, Farrell M

出版信息

Can Anaesth Soc J. 1986 Mar;33(2):173-7. doi: 10.1007/BF03010828.

Abstract

Barbiturate coma is still recommended for brain protection during periods of temporary focal ischaemia such as during carotid endarterectomy. We tested the hypothesis that a single dose of barbiturate given before a period of protracted severe focal ischaemia would protect against focal cerebral infarction. Sixteen cats had the proximal left middle cerebral artery (MCA) occluded. Eight cats received halothane alone titrated to keep their pulse and blood pressure within the normal range. Eight cats received, in addition to halothane, a bolus of thiopentone sufficient to produce an isoelectric EEG immediately prior to MCA occlusion. Six hours after the occlusions the animals were sacrificed and the brains scored histologically to assess both size and severity of ischaemia. There was no statistically significant difference in the size or severity of the infarcts between the groups. We conclude from this study that the extent of the histological injury was not reduced by a single prophylactic bolus of thiopentone given before prolonged focal cerebral ischaemia.

摘要

在诸如颈动脉内膜切除术等短暂局灶性缺血期间,巴比妥类药物昏迷仍被推荐用于脑保护。我们检验了这样一个假设,即在长时间严重局灶性缺血之前给予单剂量巴比妥类药物可预防局灶性脑梗死。16只猫的左大脑中动脉(MCA)近端被阻塞。8只猫仅接受氟烷滴定,以使其脉搏和血压保持在正常范围内。8只猫除了接受氟烷外,在MCA阻塞前还接受了足以立即产生等电位脑电图的大剂量硫喷妥钠。阻塞6小时后处死动物,并对大脑进行组织学评分,以评估缺血的大小和严重程度。两组之间梗死灶的大小或严重程度没有统计学上的显著差异。我们从这项研究得出结论,在长时间局灶性脑缺血之前给予单次预防性大剂量硫喷妥钠并不能减轻组织学损伤的程度。

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