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利多卡因诱发大鼠癫痫发作时的局部脑血流

Local cerebral blood flow during lidocaine-induced seizures in rats.

作者信息

Tommasino C, Maekawa T, Shapiro H M

出版信息

Anesthesiology. 1986 Jun;64(6):771-7. doi: 10.1097/00000542-198606000-00016.

DOI:10.1097/00000542-198606000-00016
PMID:3717640
Abstract

Neurophysiologic and local cerebral metabolic mapping techniques indicate that seizures associated with lidocaine toxicity originate in subcortical brain structures. Normally local cerebral blood flow (l-CBF) is quantitatively coupled to local cerebral metabolic rate for glucose (l-CMRg). In the present study the response of l-CBF to a lidocaine-induced preconvulsive state (localized seizure activity in the absence of a grand mal seizure) was evaluated in rats anesthetized with 60% nitrous oxide. Lidocaine administered as a bolus (20 mg/kg) followed by an infusion (4 mg/kg) over 5.5 min resulted in progressive alteration in the electroencephalogram (EEG). L-CBF was studied with the 14C-iodoantipyrine autographic method when the preconvulsive EEG pattern consisted of a repetitive spike and wave complex at a frequency of 14 +/- 1 X min-1 complexes, superimposed on practically isoelectric background activity. Under these conditions high doses of lidocaine significantly (P less than 0.05) decreased (range -30% to -68%) l-CBF in 71% of the 34 brain regions studied. The greatest exception to this trend for l-CBF to decrease was observed in the limbic system wherein l-CBF remained within control ranges in eight of the 11 structures evaluated. Qualitative comparison of lidocaine l-CBF changes with l-CMRg changes obtained under similar conditions indicated a general trend for local flow and metabolism to decrease in parallel. Exceptions to this were confined to certain limbic areas (amygdala and hippocampus) in which increases in l-CMRg were more than 100% greater than slight (P greater than 0.05) increases in l-CBF.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

神经生理学和局部脑代谢图谱技术表明,利多卡因毒性相关的癫痫发作起源于皮质下脑结构。正常情况下,局部脑血流量(l-CBF)与局部脑葡萄糖代谢率(l-CMRg)在数量上相互关联。在本研究中,用60%氧化亚氮麻醉的大鼠中,评估了l-CBF对利多卡因诱导的惊厥前状态(无大发作的局部癫痫活动)的反应。静脉推注利多卡因(20mg/kg),随后在5.5分钟内输注(4mg/kg),导致脑电图(EEG)逐渐改变。当惊厥前EEG模式由频率为14±1次/分钟的重复棘波和慢波复合波组成,叠加在几乎等电位的背景活动上时,用14C-碘安替比林自显影法研究l-CBF。在这些条件下,高剂量利多卡因使34个研究脑区中的71%的l-CBF显著降低(P<0.05)(降低范围为-30%至-68%)。在边缘系统中观察到l-CBF下降趋势的最大例外,在所评估的11个结构中的8个中,l-CBF保持在对照范围内。将利多卡因引起的l-CBF变化与在类似条件下获得的l-CMRg变化进行定性比较,表明局部血流和代谢一般呈平行下降趋势。例外情况局限于某些边缘区域(杏仁核和海马体),其中l-CMRg的增加比l-CBF轻微(P>0.05)增加超过100%。(摘要截短至250字)

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J Anesth. 1990 Jul;4(3):265-9. doi: 10.1007/s0054000040265.