Cheng Qun, Fang Xiang-Yu, Qiu Rong-En
Anesthesiology Department, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China.
Kaohsiung J Med Sci. 2025 Jun;41(6):e70011. doi: 10.1002/kjm2.70011. Epub 2025 Apr 1.
Spinal cord injury (SCI) triggers secondary damage, including pain-induced hypertension, inflammation, and hemorrhage, impairing recovery. This study evaluated the efficacy of general anesthesia with preemptive propofol administration in mitigating secondary damage in SCI rats. SCI was induced in rats using a contusion model. Propofol (100 mg/kg) was administered intraperitoneally either 30 min before (preemptive) or 30 min after intermittent tail shock. Systolic blood pressure (SBP), body weight, food intake, inflammatory markers (interleukin-1 beta [IL-1β], interleukin-6 [IL-6]), hemorrhage markers, and serum levels of SCI biomarkers (glial fibrillary acidic protein [GFAP], myelin basic protein [MBP]) were measured. Functional recovery was assessed over 28 days using the Basso, Beattie, and Bresnahan (BBB) scale, horizontal ladder test, and rotarod test. Preemptive propofol administration effectively mitigated pain-induced hypertension, enhanced body weight and food intake, and reduced inflammatory markers to levels comparable to unstimulated SCI rats. In contrast, propofol administered post-stimulation was less effective. Preemptive administration significantly decreased GFAP levels and preserved MBP levels. Importantly, preemptive intervention reduced levels of hemoglobin and alpha hemoglobin, while post-stimulation intervention showed no significant effect on hemorrhage. Behavioral assessments demonstrated improved locomotor recovery, motor coordination, and balance in preemptively treated rats compared to delayed or no intervention. Preemptive administration of propofol effectively reduces pain-induced hypertension, inflammation, and gliosis while preserving myelin integrity and enhancing functional recovery in SCI rats. This intervention demonstrates significantly greater efficacy compared to delayed administration, underscoring the critical importance of timely treatment in mitigating secondary damage and improving outcomes after SCI.
脊髓损伤（SCI）会引发继发性损伤，包括疼痛性高血压、炎症和出血，从而妨碍恢复。本研究评估了预先给予丙泊酚的全身麻醉在减轻SCI大鼠继发性损伤方面的疗效。使用挫伤模型在大鼠中诱导SCI。丙泊酚（100mg/kg）在间歇性尾部电击前30分钟（预先给药）或后30分钟腹腔注射。测量收缩压（SBP）、体重、食物摄入量、炎症标志物（白细胞介素-1β[IL-1β]、白细胞介素-6[IL-6]）、出血标志物以及SCI生物标志物（胶质纤维酸性蛋白[GFAP]、髓鞘碱性蛋白[MBP]）的血清水平。使用Basso、Beattie和Bresnahan（BBB）量表、水平阶梯试验和转棒试验在28天内评估功能恢复情况。预先给予丙泊酚可有效减轻疼痛性高血压，增加体重和食物摄入量，并将炎症标志物降低至与未受刺激的SCI大鼠相当的水平。相比之下，刺激后给予丙泊酚的效果较差。预先给药显著降低了GFAP水平并维持了MBP水平。重要的是，预先干预降低了血红蛋白和α血红蛋白水平，而刺激后干预对出血无显著影响。行为评估表明，与延迟干预或不干预相比，预先治疗的大鼠运动恢复、运动协调性和平衡能力有所改善。预先给予丙泊酚可有效减轻疼痛性高血压、炎症和胶质增生，同时保持髓鞘完整性并促进SCI大鼠的功能恢复。与延迟给药相比，这种干预显示出显著更高的疗效，强调了及时治疗在减轻SCI继发性损伤和改善预后方面至关重要。
