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当脑温得到控制时,氟烷可减轻大鼠的局灶性缺血性损伤。

Halothane reduces focal ischemic injury in the rat when brain temperature is controlled.

作者信息

Warner D S, Ludwig P S, Pearlstein R, Brinkhous A D

机构信息

Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA.

出版信息

Anesthesiology. 1995 May;82(5):1237-45; discussion 27A. doi: 10.1097/00000542-199505000-00019.

Abstract

BACKGROUND

Previous work has demonstrated that rats anesthetized with halothane during focal cerebral ischemia have better histologic and neurologic outcome than do rats undergoing the same insult when awake. The purpose of this experiment was to determine whether this difference persists when brain temperature is held similar in halothane-anesthetized and awake experimental groups.

METHODS

Two ischemia experiments were performed. In both, the middle cerebral artery was occluded for 90 min. Temperature was monitored from a radiotelemetered thermistor implanted in the cerebral cortex. Four days after ischemia, infarct volume and neurologic function were assessed. In experiment 1, brain temperature was not controlled in awake rats. Temperature in rats anesthetized with halothane, approximately 1 minimum alveolar concentration, was regulated by servomechanism by surface heating or cooling to replicate the temperature profiles generated by awake animals. To address methodologic issues regarding infarct volume analysis, a subset of nine rats was examined for the effect of the histologic staining technique and the mathematical modeling algorithms used for computation of infarct volume values. In experiment 2, the brain temperature of awake and halothane-anesthetized rats was maintained normothermic (38.0 degrees C) throughout ischemia and early recirculation.

RESULTS

In experiment 1 no difference between groups was observed for cortical (halothane 146 +/- 95 mm3 and awake 126 +/- 108 mm3; P = 0.64) or subcortical (halothane 110 +/- 48 mm3 and awake 100 +/- 66 mm3; P = 0.66) infarct volume. Neurologic function was also similar between groups. Total infarct volume was approximately 11% greater when histologic sections were stained with hematoxylin and eosin than when they were stained with nitro blue tetrazolium, although volumes correlated closely between the two techniques (r2 = 0.996). Analysis by orthogonal or frustum projection from two-dimensional planimetric areas to three-dimensional volumes resulted in nearly identical values (r2 = 0.999). In experiment 2, halothane-anesthetized rats experienced a 46% reduction in cortical infarct volume (halothane 106 +/- 97 mm3 and awake 197 +/- 103 mm3; P = 0.03). The incidence of hemiparesis was reduced in the anesthetized group (P = 0.03).

CONCLUSIONS

When brain temperature was maintained normothermic throughout the focal ischemic insult, a neurologic and histologic protective effect for halothane anesthesia was observed. This effect of halothane was not sufficient to persist when large variations in brain temperature were allowed. Regulation of brain temperature is a critical factor in the determination of the effects of anesthetics on focal ischemic brain damage.

摘要

背景

先前的研究表明,在局灶性脑缺血期间用氟烷麻醉的大鼠,与清醒时遭受相同损伤的大鼠相比,具有更好的组织学和神经学结果。本实验的目的是确定当氟烷麻醉组和清醒实验组的脑温保持相似时,这种差异是否仍然存在。

方法

进行了两项缺血实验。在两项实验中,大脑中动脉均闭塞90分钟。通过植入大脑皮层的无线电遥测热敏电阻监测温度。缺血4天后,评估梗死体积和神经功能。在实验1中,未对清醒大鼠的脑温进行控制。用氟烷(约1个最低肺泡浓度)麻醉的大鼠,通过表面加热或冷却的伺服机制调节温度,以复制清醒动物产生的温度曲线。为了解决梗死体积分析的方法学问题,对9只大鼠的一个子集进行了检查,以观察组织学染色技术和用于计算梗死体积值的数学建模算法的效果。在实验2中,清醒和氟烷麻醉大鼠在整个缺血和早期再灌注过程中均维持正常体温(38.0℃)。

结果

在实验1中,两组之间在皮质(氟烷组146±95mm³,清醒组126±108mm³;P = 0.64)或皮质下(氟烷组110±48mm³,清醒组100±66mm³;P = 0.66)梗死体积方面未观察到差异。两组之间的神经功能也相似。当组织学切片用苏木精和伊红染色时,总梗死体积比用硝基蓝四氮唑染色时大约大11%,尽管两种技术的体积密切相关(r² = 0.996)。通过从二维平面测量区域到三维体积的正交或截头投影分析得出的结果几乎相同(r² = 0.999)。在实验2中,氟烷麻醉的大鼠皮质梗死体积减少了46%(氟烷组106±97mm³,清醒组197±103mm³;P = 0.03)。麻醉组偏瘫的发生率降低(P = 0.03)。

结论

当在局灶性缺血损伤全过程中维持正常体温时,观察到氟烷麻醉具有神经学和组织学保护作用。当允许脑温有较大变化时,氟烷的这种作用不足以持续存在。脑温调节是确定麻醉药对局灶性缺血性脑损伤影响的关键因素。

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