Pelligrino D A, Miletich D J, Hoffman W E, Albrecht R F
Anesthesiology. 1984 May;60(5):405-12. doi: 10.1097/00000542-198405000-00003.
Studies to date on the influence of N2O on cerebral blood flow (CBF) and metabolism in dogs, rodents, and humans have produced conflicting results. In the present study the authors have employed techniques in the awake, freely breathing nonstressed goat that allowed the authors to 1) serially obtain rapidly frozen cerebral cortical biopsy specimens (for labile metabolite assay) and 2) measure changes in cerebral O2 metabolism (CMRO2) and total and regional CBF (rCBF). Thus, with each animal utilized as its own control, the authors studied N2O effects on the above variables. Two determinations of the effects of 1 h of N2O (70% via a mask) on these variables were performed on each animal. Following introduction of N2O, PaCO2 and arterial blood pressure did not change, but arterial epinephrine levels declined over the 60-min period. Total CBF increased in the first 5 min of N2O exposure, reached a maximum of 165% control at 15 min, and then decreased to 143% control at 60 min. rCBF evaluations showed that much of this CBF increase was confined to cerebral cortical structures (188-246% control at 60 min). Over the same period cortical CMRO2 increased to 170% of control. No appreciable changes in the levels of high-energy phosphates or glycolytic intermediates were found at 60 min of N2O. The authors attribute the described changes solely to the presence of N2O and not to sympathoadrenal influences, altered ventilation, or anything related to the experimental preparation, and they conclude that N2O (at least in goats) is associated with a marked cerebral cortical "activation".
迄今为止,关于一氧化二氮(N2O)对犬、啮齿动物和人类脑血流量(CBF)及代谢影响的研究结果相互矛盾。在本研究中,作者采用了适用于清醒、自主呼吸且无应激状态山羊的技术,使作者能够:1)连续获取快速冷冻的大脑皮质活检标本(用于不稳定代谢物检测);2)测量脑氧代谢(CMRO2)以及全脑和局部脑血流量(rCBF)的变化。因此,以每只动物自身作为对照,作者研究了N2O对上述变量的影响。对每只动物进行了两次关于1小时N2O(通过面罩给予70%)对这些变量影响的测定。引入N2O后,动脉血二氧化碳分压(PaCO2)和动脉血压未发生变化,但动脉肾上腺素水平在60分钟内下降。在N2O暴露的最初5分钟内,全脑CBF增加,在15分钟时达到对照值的165%的最大值,然后在60分钟时降至对照值的143%。rCBF评估显示,这种CBF增加大部分局限于大脑皮质结构(在60分钟时为对照值的188 - 246%)。在相同时间段内,皮质CMRO2增加至对照值的170%。在N2O作用60分钟时,未发现高能磷酸盐或糖酵解中间产物水平有明显变化。作者将所描述的变化完全归因于N2O的存在,而非交感肾上腺影响、通气改变或与实验准备相关的任何因素,并得出结论:N2O(至少在山羊中)与显著的大脑皮质“激活”有关。